In infants older than 3 months, which finding is a better indicator of developmental dysplasia of the hip (DDH)?

• A. Instability
• B. Galeazzi and Klisic tests
• C. Barlow and Ortolani
• D. Trendelenburg

Answer: (B)

When infants are older than about three months, DDH is best picked up by signs that reflect the actual position of the hip joint rather than trying to dislocate or reduce a hip that is already more chronically seated in the socket. The Galeazzi (Allis) sign checks for leg-length difference with the infant’s hips and knees flexed; if one knee sits lower, it suggests the femoral head on that side isn’t properly seated in the acetabulum, pointing to DDH. The Klisic test assesses where the femoral head sits by palpating along the groin while guiding the hip, so abnormal placement of the head relative to the acetabulum produces a positive finding. These age-appropriate signs are more reliable than the newborn maneuvers because Barlow and Ortolani depend on easily dislocatable hips, which become less sensitive as the child grows. Trendelenburg is not a practical DDH screen in infants, as it reflects later hip abductor function rather than early hip joint morphology.