A physical examination of a baby by a doctor is a standard procedure after any birth. Babies at risk of having a hip dislocation should be checked specifically for symptoms associated with the condition. A doctor can examine a baby for hip dislocation, but he may need further testing to accurately diagnose the condition.
Identification
Hip dislocation frequently occurs in infants as a congenital condition, meaning it is present at birth. The condition is called developmental dysplasia of the hip, or DDH, and occurs in approximately 1 in every 1,000 births. More girls than boys are born with DDH and the situation can be caused by breech presentation or decreased amniotic fluid before birth. Some babies are not born with the condition, but later develop a dislocation as they grow. The sooner a hip dislocation is identified, the greater the chance of successful treatment.
Barlow Test
The Barlow test is performed to assess for sounds of the leg bone moving in and out of the hip socket. The baby is placed on her back with the legs bent at a 90-degree angle. Testing one leg at a time, the doctor places gentle pressure on the knee to push the leg back and to the side. The sound of a clunk indicates a possible dislocation and is referred to as a positive Barlow's sign.
Ortolani's Test
If a baby's hip is dislocated, the Ortolani's test is done by a physician to determine if the bone will go back into the hip joint, a term called reduction. According to the American Academy of Pediatrics, the Ortolani's test should be done with a baby lying on his back with the hips flexed at a 90-degree angle while the doctor pulls the leg forward at the hip. The sense of movement or clicking sound is the joint being put back into place.
Physical Appearance
An infant with a hip dislocation may have the physical appearance of an abnormality. One leg may appear shorter than the other; or the foot on the side of the dislocation may be turned outward. On the baby's back, the folds of skin found on the upper thigh near the buttocks may be uneven. Babies with bilateral hip dislocation may be difficult to diagnose because the legs may appear symmetrical.
Radiology
Among newborn babies, an ultrasound will show the hip socket and placement of the bone of the leg. An ultrasound may also be performed while physically maneuvering the hip during the Barlow or Ortolani's tests. An X-ray of the pelvis may be done on infants older than four months, as hip cartilage continues to develop after birth, changing into bone starting at about three months of age.
