Show
Contents loading... Editors loading... Categories loading... When refering to evidence in academic writing, you should always try to reference the primary (original) source. That is usually the journal article where the information was first stated. In most cases Physiopedia articles are a secondary source and so should not be used as references. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! Description[edit | edit source]The instability of the hip may be assessed by the Ortolani and Barlow tests, which play a big role in the clinical screening for developmental dysplasia of the hip [1]. Each hip should be examined separately [2]. An infant with a positive examination result, defined as either a positive Ortolani or Barlow sign, should be referred to an orthopedist [3].
image 1: Schematic depiction of hip joint structures' positions in hip dysplasia A - Normal, B - Dysplasia, C - Subluxation, D - Luxation Image 2: Hip joint (highlighted in green) - anterolateral view[5] This 7 minute video is a good summary of the hip joint.[6] Barlow Test[edit | edit source]Barlow’s test identifies posterior sublimations or dislocation. It is named after Dr. Thomas Geoffrey Barlow, who devised this test[7]. The Barlow test is a provocative maneuver used to reveal hip instability. The test is performed by:
The sensitivity of the Barlow maneuver with experienced hands (ranging from 87 to 97 percent) and specificity varies from 98 to 99 %. Ortolani Test[edit | edit source]The Ortolani Test was first described in 1936 by an Italian pediatrician Marino Ortolani [10]. The test is performed bu Placing the baby in a supine position with flexed hips at 90 degrees.
Watch[edit | edit source]The 5 minute videos show these tests. [12] [13] In Infants, the Degree of Instability Can Be Described As:[edit | edit source]
Hip Dysplasia Presentations in the Infant 2 Months or Older[edit | edit source]After 2-3 months of age, the Ortolani test and Barlow maneuvers are less sensitive but several other physical exam findings become more apparent:
References[edit | edit source]
Which finding does the nurse look for when assessing a newborn for developmental dysplasia of the hip?The most concerning physical exam finding is the classic Ortolani sign — the hip is felt to “clunk” into place with abduction of the hip. A Barlow sign — when the hip slides out of the socket with posteriorly directed force — also indicates risk of DDH.
Which factor contributes to the development of physiological jaundice in a newborn?Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice.
Which finding in a newborn is a behavioral response to pain?Behaviour in response to pain
Facial expressions are generally regarded as the best single behavioural indicator of pain in all age groups. A grimace, eyes squeezed shut and mouth stretched open with a tensed and curled tongue, are common expressions of pain.
Which assessment finding of a newborn requires prompt action by the nurse?Apnea is abnormal and requires prompt intervention. A respiratory rate of 50 breaths/min is still within the normal range. Tachypnea is considered to be 60 breaths/min or more. Cyanosis of the extremities or acrocyanosis is normal during the first day after birth and if the infant becomes cold.
|