Module 17, General Medical Level
A 2 year and 3 month old girl presented for evaluation. The child was
the 3 pound 5 ounce product of a 30 week gestation which was complicated
by a low birth weight and respiratory distress at birth. She was able to
sit alone and just started to crawl at 11 months. Hip abduction was 25
degrees on each side with the hips and knees extended. Popliteal angles
were 10 degrees, bilaterally. In the prone position with her hips extended,
she has 60 degrees of internal rotation bilaterally and 40 degrees of external
rotation on the right and 60 degrees of external rotation on the left.
She had a negative Barlow test.
Question 17A
Hip ultrasound should be obtained to rule out development hip dysplasia.
Question 17B
An
xray of the hip was reported by a radiologist as being normal. This means
that the parents can be reassured that they do not need to worry any longer
about the hips.
Question 17C
Because
of limited hip abduction she should be placed in an abduction hip orthosis.
Question 17D
Hip
dislocation in children with cerebral palsy is a very common condition.
Question 17E
If
a child with cerebral palsy is walking, hip dislocation will not occur.
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