Systematic Review: Diagnostic accuracy of clinical examination for dislocated hips in infants

This systematic review assesses the diagnostic accuracy of clinical examinations in identifying dislocated hips in infants, using data from nine studies that compared clinical examinations to diagnostic ultrasound as the reference. The study involved 37,859 hips with a dislocation prevalence of 0.94%. The Barlow and Ortolani maneuvers showed a sensitivity of 46% and a specificity of 99.1%, with a positive likelihood ratio of 52, highlighting their effectiveness in predicting hip dislocation. Other methods such as limited hip abduction and a clicking sound were found to have minimal diagnostic utility. This evidence supports the clinical utility of specific maneuvers in early detection to prevent long-term complications.

Reference (link to abstract – $ for full-text):

Abhinav Singh et al. (2024). Does This Infant Have a Dislocated Hip? The Rational Clinical Examination Systematic Review. JAMA, Published online April 15, 2024. doi:10.1001/jama.2024.2404