Symptoms and Signs – Differential Diagnosis of Ortolani's Sign

Symptoms and Signs – Differential Diagnosis of Ortolani's Sign

Ortolani's sign — a click, clunk, or popping feeling perceived and often audible when a neonate's hip is flexed at 90 degrees and abducted — signifies developmental dysplasia of the hip (DDH); it occurs when the femoral head enters or exits the acetabulum. Screening for this indicator is crucial in newborn care, as early identification and intervention for DDH enhance the neonate's prospects of developing a well formed, functional joint. Medical History and Physical Assessment During the evaluation of Ortolani's sign, the newborn must be in a relaxed position, laying supine.

Following the elicitation of Ortolani’s sign, assess the neonate for asymmetrical gluteal folds, restricted hip abduction, and discrepancies in leg length. Medical Etiologies: Developmental Dysplasia of the Hip (DDH). In cases of full dysplasia, the affected limb may have a reduced length, or the impacted hip may appear more pronounced.

GENDER INDICATOR
Most prevalent in females, developmental dysplasia of the hip (DDH) manifests Ortolani's sign, potentially accompanied with restricted hip abduction and asymmetrical gluteal folds. The infant with developmental dysplasia of the hip typically exhibits no apparent deformity or discomfort.
CULTURAL INDICATOR
A significant correlation between hip dysplasia and neonatal management techniques has been established. For example, the Inuit and Navajo populations exhibit a significant prevalence of developmental dysplasia of the hip (DDH), potentially linked to their customs of swaddling infants in blankets or securing them to cradleboards. In societies where women transport infants on their backs or hips, such as in the Far East and Africa, hip dysplasia is infrequently observed.

Particular Considerations Ortolani's sign can be observed exclusively within the initial 4 to 6 weeks of life; this period also represents the ideal timeframe for effective corrective intervention. Delayed treatment of DDH may result in degenerative hip alterations, lordosis, joint deformities, and soft tissue complications. cellular injury. Diverse abduction techniques can be employed to achieve a stable joint. These techniques encompass the utilization of soft splinting apparatus and a plaster hip spica cast.

Patient Consultation
Elucidate the neonate's condition and the corresponding therapy to the parents. Instruct them on maintaining the injured limb in an abducted posture.