Presentation
Follow up of hip condition.
Patient Data
Left hip joint shows shallow acetabulum, dislocated femoral head, and small size of femoral epiphysis with decreased density, in keeping with significant developmental dysplasia of the left hip.
Secondary left lower limb shortening is noted.
Normal alignment of right femoral epiphysis.
Case Discussion
The case presented at the age of 2 months for screening of developmental dysplasia of the hip as her older siblings have similar condition. The left hip gave positive Barlow and Ortolani tests.
Ultrasound was requested and showed a shallow acetabulum, significant displacement of the femoral head from the acetabulum, acetabular cup accommodating <1/2 of femoral head (significant dislocation) and Alpha angle =47° (Normal > 60). Treatment with hip abduction brace was recommended.
At present, the patient came for follow up of developmental dysplasia of the left hip, with current left lower limb shortening and positive Galeazzi sign. The patient lost follow up through the last 6 months with neglected treatment and presented with classical radiographic features of developmental dysplasia of the hip.
The case shows Puttis triad
increased acetabular angle
small capital femoral epiphysis
superolateral displacement (superior to Hilgenreiner’s line and lateral to Perkin’s line)
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