An 8-month-old infant with suspected developmental dysplasia of the hip is examined supine with both hips and knees fully flexed. One knee sits visibly lower than the other. What is this sign called, and in which situation will it fail to appear?
- A Galeazzi sign; it is absent in bilateral hip dislocation ✓
- B Ortolani sign; it is absent in subluxation
- C Telescoping sign; it is absent in teratologic dislocation
- D Barlow sign; it is absent in older infants
Correct answer: A. Galeazzi sign; it is absent in bilateral hip dislocation
Explanation
Unequal knee heights with the hips and knees flexed is the Galeazzi or Allis sign, produced by apparent shortening of the femur on the dislocated side. It becomes more useful than Ortolani and Barlow tests after about 3 months, when capsular tightening makes the clunk tests unreliable. Because the test depends on a difference between the two sides, bilateral dislocation produces equal knee heights and a falsely normal examination.
Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.
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