Clinical findings in infants and children with developmental dysplasia of the hip

	Unilateral	Bilateral*
Birth to 3 months of age
Hip instability^¶ (demonstrated by positive Ortolani or Barlow tests^Δ)	Yes	Yes
Asymmetric leg creases (inguinal, gluteal, thigh, or popliteal)	Yes	No
Apparent shortening of femur (ie, positive Galeazzi sign^Δ [also called Allis or Perkins sign])	Yes	No
3 to 12 months of age
Limitation of hip abduction in 90° of flexion	Yes	Yes
Apparent shortening of the femur (ie, positive Galeazzi sign^Δ [also called Allis or Perkins sign])	Yes	No
Laterally rotated posture in prone position (ie, increased femoral anteversion)	Yes	Yes
Marked asymmetry of leg creases (inguinal, gluteal, thigh, or popliteal)	Yes	No
Klisic test^◊	Yes	Yes
After the child begins to walk
Excessive lordosis	No	Yes
Prominent greater trochanter	Yes	Yes
Gluteus medius lurch (Trendelenburg gait)	Yes	Yes
Positive Trendelenburg sign	Yes	Yes
Short leg limp, with toe-heel gait and out-toeing	Yes	No
Increasing adduction contracture of the hip, with compensatory genu valgum	Yes	Yes

This table is intended for use in conjunction with UpToDate content on developmental dysplasia of the hip.

* Developmental dysplasia of the hip is bilateral in as many as 37% of cases.
¶ Hip instability is a diagnostic finding.
Δ Refer to UpToDate content on clinical features of developmental dysplasia of the hip for details regarding performance and interpretation of examination maneuvers.
◊ The Klisic test is performed by placing the index finger on the anterior-superior iliac spine and the middle finger on the greater trochanter. An imaginary line between these points passes through or above the umbilicus in a child without developmental dysplasia of the hip (negative Klisic test). The line passes below the umbilicus if the hip is dislocated (positive Klisic test) because the greater trochanter is in a more superior position.

Adapted from: The hip. In: Tachdjain MO. Clinical Pediatric Orthopedics. The Art of Diagnosis and Principles of Management. Appleton & Lange, Stamford, CT 1997. p.167.

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Clinical findings in infants and children with developmental dysplasia of the hip