Which hip examination maneuver is used to detect a dislocated hip in a newborn by abducting the hip and feeling for a clunk?

• A. Ortolani test
• B. Barlow test
• C. Galeazzi sign
• D. Allis sign

Answer: (A)

This item assesses neonatal screening for developmental dysplasia of the hip using the Ortolani maneuver. In this test, the hip is placed flexed to about 90 degrees with the knee also flexed, and then the thigh is gently abducted while upward pressure is applied to the femoral head. If a dislocated hip is present, the femoral head relocates into the acetabulum and a distinct clunk is felt or heard as the head slides back into place. This clunk indicates a reducible dislocation, which is exactly what Ortolani is designed to detect.

The Barlow test, by contrast, tries to dislocate a hip that is unstable by adducting the thigh and applying posterior pressure, so a positive finding suggests a hip that can be dislocated but isn’t yet reduced. Galeazzi and Allis signs look for leg length discrepancy or knee height differences to infer hip problems, not for a clunk during abduction.