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Media Gallery

Galeazzi sign is classic identifier of unilateral hip dislocation. Patient lies supine, with hips and knees flexed. Examination should demonstrate that one leg appears shorter than other. Although this appearance is usually due to hip dislocation, it is important to realize that any limb-length discrepancy results in positive Galeazzi sign.
Typical radiographic evaluation of developmental dysplasia of hip (DDH). From anteroposterior radiograph of hips, horizontal line (Hilgenreiner line) is drawn between each triradiate cartilage. Next, lines are drawn perpendicular to Hilgenreiner line through superolateral edge of acetabulum (Perkin line), dividing hip into 4 quadrants. Proximal medial femur should be in lower medial quadrant, or ossific nucleus of femoral head, if present (usually observed in patients aged 4-7 months), should be in lower medial quadrant. Acetabular index is angle between Hilgenreiner line and line drawn from triradiate cartilage to lateral edge of acetabulum. Typically, this angle decreases with age and should measure less than 20° by 2 years of age. Shenton line is drawn from medial aspect of femoral neck to inferior border of pubic rami. It should create smooth arc that is not disrupted. Disruption of Shenton line indicates presence of some degree of hip subluxation.
Radiographs from 6-year-old child who underwent open reduction with capsular plication, femoral shortening, and pelvic (Pemberton) osteotomy.

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Author

Junichi Tamai, MD Assistant Professor, Division of Pediatric Orthopaedics, Director of Physician Assistants, Cincinnati Children’s Hospital Medical Center; Assistant Professor of Clinical Orthopaedic Surgery Affiliated, Department of Orthopaedics, University of Cincinnati College of Medicine

Junichi Tamai, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, American Medical Association, Pediatric Orthopaedic Society of North America, Cincinnati Pediatric Society

Disclosure: Received honoraria from Oakstone Board Review for speaking and teaching.

Coauthor(s)

James J McCarthy, MD, FAAOS, FAAP Director, Division of Orthopedic Surgery, Cincinnati Children's Hospital; Professor, Department of Orthopedic Surgery, University of Cincinnati College of Medicine

James J McCarthy, MD, FAAOS, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Orthopaedic Association, Pennsylvania Medical Society, Philadelphia County Medical Society, Pennsylvania Orthopaedic Society, Pediatric Orthopaedic Society of North America, Orthopaedics Overseas, Limb Lengthening and Reconstruction Society, Alpha Omega Alpha, American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Orthopaedic Surgeons

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Orthopediatrics, Phillips Healthcare, POSNA<br/>Serve(d) as a speaker or a member of a speakers bureau for: Synthes<br/>Received research grant from: University of Cincinnati<br/>Received royalty from Lippincott Williams and WIcins for editing textbook; Received none from POSNA for board membership; Received none from LLRS for board membership; Received consulting fee from Synthes for none.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

B Sonny Bal, MD, JD, PhD, MBA CEO and President, SINTX Technologies, Salt Lake City, UT

B Sonny Bal, MD, JD, PhD, MBA is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: SINTX Technologies.

Chief Editor

William L Jaffe, MD Clinical Professor of Orthopedic Surgery, New York University Grossman School of Medicine; Vice Chairman, Department of Orthopedic Surgery, New York University Hospital for Joint Diseases

William L Jaffe, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, Eastern Orthopaedic Association, New York Academy of Medicine

Disclosure: Received consulting fee from Stryker Orthopaedics for speaking and teaching.

Additional Contributors

Sections Developmental Dysplasia of the Hip (DDH)
Overview
Presentation
Workup
Treatment
Questions & Answers
Media Gallery
References

Developmental Dysplasia of the Hip (DDH) Questions & Answers

References

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