The nurse is assessing a 4-week-old infant during a routine office visit. Which assessment finding is most likely to alert the nurse to the presence of right hip developmental dysplasia?

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11ecbb05_cae9_4b97_b433_fb9714dfb590_MD0009_00 Developmental dysplasia of the hip (DDH) is a set of hip abnormalities ranging from mild dysplasia of the hip joint to full dislocation of the femoral head. Because it is much easier to treat during infancy, DDH screening is a standard assessment for newborns and infants. Manifestations in infants age <2-3 months include: The presence of extra inguinal or thigh folds Laxity of the hip joint on the affected side. Hip laxity/instability is tested through the Barlow and Ortolani maneuvers. However, these tests must only be performed by an experienced health care provider to avoid further hip injury. If DDH is not treated, these signs disappear after age 2-3 months due to the development of muscle contractures. (Option A) Limited hip abduction occurs as contractures develop, particularly once the infant is age >3 months. (Option C) In children with one-sided DDH, the affected leg may be shorter than the opposite leg. However, this is also apparent after age 3 months. (Option D) If DDH is not corrected in infancy, additional manifestations develop when the child learns to walk. These signs include a notable limp, walking on the toes, and a positive Trendelenburg sign (pelvis tilts down on unaffected side when standing on the affected leg). In the case of bilateral DDH, the child may also develop a waddling gait and severe lordosis. Educational objective: Screening for developmental dysplasia of the hip is a standard part of infant assessment. Manifestations in infants age <2-3 months include the presence of extra inguinal or thigh folds and laxity of the hip joint on the affected side. After age 3 months, limited hip abduction and limb shortening on the affected side are evident. A pelvic tilt is noted once the child learns to walk.

The Nurse Is Assessing a 4-Week-Old Infant During a Routine