Congenital Diagnosis
Popularity (by total correct streak): 0
Popularity (by number of users): 1
| Define developmental dysplasia of the hip (DDH) or congenital hip dislocation (CHD). | The acetabulum and femoral head are not normally aligned due to shallow or small acetabulum with poor lateral borders. | |
| What are the grades of developmental dysplasia of the hip? | Subluxatable, dislocated, dislocatable, and teratologic. | |
| Define subluxatable developmental dysplasia of the hip. | Femoral head can be partially displaced to the rim of the acetabulum, it slides laterally, but not all the way out of the socket. | |
| Define dislocated developmental dysplasia of the hip. | Femoral head lies completely outside the hip socket but can be reduced with manual pressure. | |
| Define dislocatable developmental dysplasia of the hip. | Femoral head in socket, but can be displaced completely outside acetabulum with manual pressure. | |
| Define teratologic developmental dysplasia of the hip. | Femoral head lies completely outside the hip socket, and cannot be reduced with manual pressure, deformity of joint surfaces is significant and usually related to other developmental anomaly such as arthrogryposis or myelomeningocele. | |
| What are the treatment considerations for subluxatable, dislocated, and dislocatable developmental dysplasia of the hip? | Hip kept abducted and flexed with femoral head in acetabulum to deepen it and maintain correct shape and to tighten ligaments and joint capsule to provide extra joint stability. | |
| Who is at risk for DDH? | Females (relaxin), firstborn, left hip, breech birth, multiples, Native American and Japanese cultures. | |
| What are predisposing factors in DDH? | Low tone, ligamentous laxity, hypertonus in adduction/IR, excessive femoral anteversion, shallow acetabulum. | |
| What are the signs and symptoms of a dislocation? | Lack of normal hip flexion contractures, limited abduction ROM, asymmetrical skin folds in buttocks and adductor region, leg length discrepancies, telescoping of flexed, adducted thigh. | |
| What is indicated with a difference in anterior view in supine with hip and knee flexion? | A tibial difference, not hip. | |
| What is indicated with a difference in lateral view in supine with hip and knee flexion? | Femoral difference. | |
| Which motion is most limited when hip is dislocated? | Abduction. | |
| Describe Barlow’s test. | Supine, flex and abduct hip with full flexion of knee then adduct hip and push down and out, if subluxatable femoral head will slide to edge of acetabulum, if dislocatable it will slip out over posterior edge, will feel or hear click/clunk. | |
| Describe Ortolani test. | Supine, hip dislocated in flexion and adduction, abduct hip with slight traction to greater trochanter, resistance at 30-40 degrees abduction with click or jerk with increased abduction if femoral head slides over acetabular ridge into acetabulum, | |
| Is the Ortolani test valid for teratologic hips? | No, only for dislocated hips. | |
| What may cause a negative Ortolani tests after 2 months of age? | Soft tissue contractures. | |
| What are the painless gait abnormalities in developmental dysplasia of the hip? | Positive Trendelenburg on involved side, bilaterally involved waddling gait, limp, shortened leg length. | |
| How is developmental dysplasia of the hip diagnosed? | Clinical signs/symptoms, ultrasound, MRI, X-ray. | |
| What is the medical management for developmental dysplasia of the hip? | Hold hip in position of flexion with abduction (hip stability). | |
| What are potential complications of the Pavlik harness? | Avascular necrosis of femoral head (too much flexion or abduction), femoral nerve palsy, inferior dislocation, erosion of the posterior rim of the acetabulum. | |
| At what age is the Pavlik harness used? | 0-6 months. | |
| What is the medical management for developmental dysplasia of the hip from 6-24 months of age? | Open or closed reduction, leg traction, hip spica case, abduction brace after spica cast. | |
| What is the medical management for developmental dysplasia of the hip over 2 years of age? | Open reduction followed by hip spica cast. | |
| What are the main areas of concern for developmental hip dysplasia regarding therapy? | Muscle atrophy, contractures, DD, gait and standing activities. | |
| What muscles may atrophy in developmental hip dysplasia? | Gluteus maximus and medius, iliopsoas, quadriceps, and hamstrings. |
Quisition is a browser-based flashcard system that repeats old cards and introduces new ones at optimal time intervals. You can create your own card packs or use those developed by others.
