Which finding is a better indicator of developmental dysplasia of the hip (DDH) in infants?

• A. Galeazzi and Klisic tests with limited abduction and apparent thigh-length discrepancy
• B. Normal hip exam
• C. Positive Ortolani only
• D. Family history of DDH

Answer: (A)

DDH in infants is best picked up when the exam shows both a limb-length difference and restricted hip movement, demonstrated by the Galeazzi (Allis) sign and the Klisic test. The Galeazzi sign is checked with the baby lying on the back, hips and knees bent to 90 degrees; if one knee sits lower than the other, it suggests that one femoral head is not seated in the acetabulum, pointing to dislocation on that side. When you also see limited hip abduction, that loss of outward movement indicates the joint’s instability and the acetabulum’s inadequate coverage. The Klisic test adds confirmation by tracing the location of the femoral head relative to the greater trochanter; an abnormal position of the head reinforces the suspicion of DDH.

A normal hip exam doesn’t rule out DDH, particularly early on. A positive Ortolani test shows a reducible dislocation but can miss other cases or be less reliable at certain ages. Family history raises risk but is not a direct exam finding. So the combination of Galeazzi with limited abduction and thigh-length discrepancy provides the strongest, most informative indicator of DDH in infants.