Detecting developmental dysplasia of the hip

Recent guidelines from the American Academy of Pediatrics mandate the universal screening of all newborns for developmental hip dysplasia, in an effort to promote prompt recognition and treatment of this condition. The effectiveness of universal screening hinges on the appropriate education, training, and experience of health care providers. This article reviews the normal embryologic, natal, and postnatal development of the hip. Historical risk factors that may have an impact on this developmental sequence are outlined. A step-by-step guide to the examination of the hip is offered, along with a discussion of the sensitivity and specificity of the Ortolani and Barlow maneuvers. Clear guidelines for referral are presented. The indications for the use of ultrasound studies as a secondary screening tool are outlined. Treatment options and important aspects of counseling and teaching families are reviewed.