Ortolani test

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Ortolani test
Gray342.png
Hip-joint, front view.
Synonyms Ortolani maneuver
Purposeexam developmental dysplasia of the hip

The Ortolani test is part of the physical examination for developmental dysplasia of the hip, along with the Barlow maneuver. [1] Specifically, the Ortolani test is positive when a posterior dislocation of the hip is reducible with this maneuver.[ citation needed ] This is part of the standard infant exam performed preferably in early infancy.[ citation needed ]The Ortolani test is named after Marino Ortolani, who developed it in 1937. [2]

Contents

Procedure

The Ortolani test is performed with the Barlow maneuver and inspection of the hip joint and legs. It relocates the dislocation of the hip joint that has just been elicited by the Barlow maneuver. [3]

The Ortolani test is performed by an examiner first flexing the hips and knees of a supine infant to 90°, then with the examiner's index fingers placing anterior pressure on the greater trochanters, gently and smoothly abducting the infant's legs using the examiner's thumbs. [3]

Interpretation

Right hip-joint from the front. Gray339.png
Right hip-joint from the front.

A positive sign is a distinctive 'clunk' which can be heard and felt as the femoral head relocates anteriorly into the acetabulum:. [4]

The latest evidence suggests that clinical tests are not sufficiently reliable for diagnosing developmental dysplasia of the hip. [5]

Related Research Articles

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<span class="mw-page-title-main">Sacroiliac joint</span> Joint of the pelvis and spine

The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is strong, supporting the entire weight of the upper body. It is a synovial plane joint with irregular elevations and depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one on the right, that often match each other but are highly variable from person to person.

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A joint dislocation, also called luxation, occurs when there is an abnormal separation in the joint, where two or more bones meet. A partial dislocation is referred to as a subluxation. Dislocations are often caused by sudden trauma on the joint like an impact or fall. A joint dislocation can cause damage to the surrounding ligaments, tendons, muscles, and nerves. Dislocations can occur in any major joint or minor joint. The most common joint dislocation is a shoulder dislocation.

<span class="mw-page-title-main">Dysplasia</span> Abnormal development, at macroscopic or microscopical level

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<span class="mw-page-title-main">Thomas test</span>

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X-rays of hip dysplasia are one of the two main methods of medical imaging to diagnose hip dysplasia, the other one being medical ultrasonography. Ultrasound imaging yields better results defining the anatomy until the cartilage is ossified. When the infant is around 3 months old a clear roentgenographic image can be achieved. Unfortunately the time the joint gives a good x-ray image is also the point at which nonsurgical treatment methods cease to give good results.

References

  1. US Preventive Services Task Force (March 2006). "Screening for developmental dysplasia of the hip: recommendation statement". Pediatrics. 117 (3): 898–902. doi:10.1542/peds.2005-1995. PMID   16510673.
  2. Dwyer NS (June 1987). "Congenital dislocation of the hip: to screen or not to screen". Archives of Disease in Childhood. 62 (6): 635–7. doi:10.1136/adc.62.6.635. PMC   1778433 . PMID   3619484.
  3. 1 2 Parrales, Hugo (2017). "Maniobras de Ortolani y Barlow". CerebroMedico.
  4. Storer SK, Skaggs DL (October 2006). "Developmental dysplasia of the hip". American Family Physician. 74 (8): 1310–6. PMID   17087424.
  5. Singh, Abhinav; Wade, Ryckie George; Metcalfe, David; Perry, Daniel C. (14 May 2024). "Does This Infant Have a Dislocated Hip?: The Rational Clinical Examination Systematic Review". JAMA. 331 (18): 1576. doi:10.1001/jama.2024.2404.