Skip to main navigation
Skip notifications
Access to POEMs and Essential Evidence Plus will no longer be included in CMA membership as of Dec. 1, 2023.
Search
Clicky hips don't necessarily mean dysplasia in infants
Clinical Question
How common is hip dysplasia in infants who are referred for the evaluation of clicky hips?
Bottom line
Most infants with a hip click but normal results on the Ortolani test and Barlow maneuver do not have hip dysplasia. 3b
Reference
Study design: Cross-sectional
Funding: Unknown/not stated
Setting: Outpatient (specialty)
Synopsis
These authors from the United Kingdom report the outcomes of 362 infants referred over a 20-year period for the evaluation of "clicky" hips (I love this expression—it could have come from an episode of Doctor Who). Each infant underwent clinical and sonographic assessments. The authors don't describe any paired independent assessments or other measures that would give me great trust in their methodology. The infants were 14 weeks of age on average and two thirds were female. Nearly all (97%) of the infants had normal hips. A few children had mild abnormalities that resolved spontaneously on follow up. Only 2 children had moderate dysplasia or an irreducible dislocation. Finally, the few children with true dysplasia had unilateral limited abduction.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Comments
Interesting . Asymmetrical thigh crease may be another indicator ?
good poem
Malgré le fait que la majorité des bébés n’ont pas une anomalie confirmées dans l’escalier examens paracliniques, il faut tout de même les faire. Je suppose qu’avec l’experience nos habilités d’examen physiques vont s’améliorer et qu’on demande moins de tests.
Study speaks well for newborn assessments of Ortolanis sign to screen hip dysfunction
bad poem
The difference between clicks and clunks
During my first five years in practice as a rural physician I sent a fair number of babies with clicky hips for a pediatric second opinion .... then finally one day a baby turned up with a clunk. Only then did I appreciate the difference between clicks which are common, and clunks which are rarer and apparently more closely associated with hip dysplasia.
This is a kind of kinesthetic learning which you really can't describe in writing. As a teacher of family medicine, I think we need some kind of kinesthetic teaching model for our learners.
Excellent