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Developmental dysplasia of the hip

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of developmental dysplasia of the hip are prepared by our editorial team based on guidelines from the American Academy of Orthopaedic Surgeons (AAOS 2022), the Dutch Orthopaedic Society (DOS 2022), the American College of Radiology (ACR 2019), and the Pediatric Orthopaedic Society of North America (POSNA 2007). ...
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Screening and diagnosis

Indications for screening: as per AAOS 2022 guidelines, avoid obtaining universal ultrasound screening of newborn infants.
D
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Diagnostic investigations

Hip ultrasound
As per AAOS 2022 guidelines:
Obtain imaging before 6 months of age in pediatric patients with ≥ 1 of the following risk factors:
breech presentation
family history
history of clinical instability
A
Consider obtaining an ultrasound in pediatric patients < 6 weeks of age with a positive instability examination to guide the decision to initiate brace treatment.
C

More topics in this section

  • Pelvic radiography

Medical management

Observation: as per AAOS 2022 guidelines, consider offering observation without a brace in pediatric patients with a clinically stable hip with morphologic ultrasound imaging abnormalities.
C

Nonpharmacologic interventions

Hip abduction braces: as per AAOS 2022 guidelines, consider offering either immediate or delayed (2-9 weeks) brace treatment for hips with a positive instability exam.
C

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  • Splinting

  • Closed reduction

  • Hip spica cast

Follow-up and surveillance

Indications for referral: as per POSNA 2007 guidelines, refer patients to an experienced orthopedic surgeon for confirmation of the suggested diagnosis.
E

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  • Clinical and imaging follow-up