miscellaneous/developmental dysplasia of the hip (ddh)

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Orthopedics

miscellaneous

developmental dysplasia of the hip (ddh)

A 4-week-old female infant, born at term, presents to a general pediatric clinic for a routine well-child check-up. She was delivered via vaginal birth, but had a documented history of breech presentation until late in the third trimester. Her older sibling was diagnosed with and treated for developmental dysplasia of the hip (DDH) as an infant. The physical examination reveals symmetric leg lengths and no click or clunk upon provocative testing (Barlow and Ortolani maneuvers). However, there is a slight asymmetry in thigh skin folds noted. The parents are concerned due to the family history and prior breech presentation. Laboratory results show a hemoglobin of 160 g/L, a white blood cell count of 10.0 x 10^9/L, and platelets of 350 x 10^9/L. Considering the infant's risk factors and physical findings, what is the most appropriate initial diagnostic step and subsequent management consideration?

Lab ParameterValueReference Range
Hemoglobin160 g/L110-180 g/L
White Blood Cell Count10.0 x 10^9/L5.0-20.0 x 10^9/L
Platelets350 x 10^9/L150-450 x 10^9/L

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