Developmental dysplasia of the hip

Case contributed by Dr Mohammad A. ElBeialy


6 months old female baby with apparent shortening of the right lower limb.

Patient Data

Age: 6 months.
Gender: Female
  • evidence of developmental dysplasia of the right hip joint (DDH) with relatively small sized right capital femoral epiphysis and shallow right acetabulum as well as supero-lateral displacement of the femoral head; it is located lateral to Perkin's line (vertical through lateral acetabular margin; should bisect middle third femoral metaphysis) and superior to Hilgenreiner's line (Drawn through right and left triradiate cartilage). 
  • increased left acetabular angle (more than 30 degree).
  • disturbed left Shenton's line.
  • normal left hip joint with normal acetabular angle,normal femoral head located medial to Perkin's line and inferior to Hilgenreiner's line as well as normal Shenton' line.
Annotated image
The dislocated femoral head lies superior and lateral to the intersection of the Hilgenreiner's and Perkin's lines. Note also the incresed acetabular angle and disturbed shenton's line on the left side.

Case Discussion

Putti's triad for developmental dysplasia of the hip include :

  1. Superolateral displacement of proximal femur .
  2. Increase in acetabular angle.
  3. Small capital femoral epiphysis.
    Other findings may include shallow acetabulum with mild sclerosis as well as formation of a false acetabulum.

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Case information

rID: 23583
Published: 25th Jun 2013
Last edited: 14th Aug 2019
Tag: hip
Inclusion in quiz mode: Included