Which test is not appropriate for developmental dysplasia of the hip in an 18-month-old?

Which test is not appropriate for developmental dysplasia of the hip in an 18-month-old?

• A. Allis sign
• B. Skinfold symmetry
• C. Galeazzi sign
• D. Ortolani maneuver

Answer: (D)

Ortolani maneuver is a maneuver designed to detect and reduce a dislocated hip in infancy. It relies on a hip that is still easily movable and reducible, and it’s most reliable when done in very young babies, typically under about 6 months of age. By 18 months, the hip joint is more mature, the acetabulum and femoral head are less easily coaxed back into alignment, and attempting this maneuver is unlikely to provide an accurate assessment. In a toddler, a dislocation (if present) is better evaluated with imaging, such as a pelvic radiograph, while clinical signs like Allis or Galeazzi can still raise suspicion, and skinfold symmetry is a rough screening clue. So the Ortolani maneuver isn’t appropriate for an 18-month-old because the hip’s anatomy and ossification at that age make that test unreliable and unnecessary.

Ortolani maneuver is a maneuver designed to detect and reduce a dislocated hip in infancy. It relies on a hip that is still easily movable and reducible, and it’s most reliable when done in very young babies, typically under about 6 months of age. By 18 months, the hip joint is more mature, the acetabulum and femoral head are less easily coaxed back into alignment, and attempting this maneuver is unlikely to provide an accurate assessment. In a toddler, a dislocation (if present) is better evaluated with imaging, such as a pelvic radiograph, while clinical signs like Allis or Galeazzi can still raise suspicion, and skinfold symmetry is a rough screening clue. So the Ortolani maneuver isn’t appropriate for an 18-month-old because the hip’s anatomy and ossification at that age make that test unreliable and unnecessary.