This instructional course lecture (Weinstein, Mubarak, Wenger 2003) covers the embryology and growth biology of the normal hip, the pathoanatomy of DDH at birth, the natural history of untreated dysplasia and dislocation, and the diagnostic tools — physical examination, ultrasound, and radiography — used to detect and classify DDH.
When evaluating a newborn for hip instability, understand that a positive Ortolani (click of entry — relocation) indicates a dislocated but reducible hip, while a positive Barlow (click of exit — provoked dislocation) indicates a locatable but unstable hip; both warrant treatment.
Radiographs are unreliable before 3–4 months — use ultrasound (Graf alpha/beta angles or Harcke dynamic stress views) in the newborn period, and reserve plain films for infants over 3 months when ossification allows meaningful interpretation.
This instructional course lecture (Weinstein, Mubarak, Wenger 2003) covers the embryology and growth biology of the normal hip, the pathoanatomy of DDH at birth, the natural history of untreated dysplasia and dislocation, and the diagnostic tools — physical examination, ultrasound, and radiography — used to detect and classify DDH.
When evaluating a newborn for hip instability, understand that a positive Ortolani (click of entry — relocation) indicates a dislocated but reducible hip, while a positive Barlow (click of exit — provoked dislocation) indicates a locatable but unstable hip; both warrant treatment.
Radiographs are unreliable before 3–4 months — use ultrasound (Graf alpha/beta angles or Harcke dynamic stress views) in the newborn period, and reserve plain films for infants over 3 months when ossification allows meaningful interpretation.