Paediatric Orthopaedics · NEET PG Preparation Orthopaedics
A 3-year-old child is brought by his parents with a painless limp. Examination reveals a positive Trendelenburg sign on the right side, limited abduc…
Practice question from Paediatric Orthopaedics (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
easy · MCQ · Q-F8BCA2
A 3-year-old child is brought by his parents with a painless limp. Examination reveals a positive Trendelenburg sign on the right side, limited abduction and internal rotation of the right hip, and apparent shortening of the right lower limb. What is the most appropriate initial diagnostic investigation of choice for this child?
- A.Anteroposterior radiograph of the pelvis
- B.Magnetic resonance imaging (MRI) of both hips
- C.Ultrasonography of the hipsCorrect answer
- D.CT scan of the pelvis with 3D reconstruction
Solution
In a child under the age of 4-6 months (or until the femoral head ossific nucleus appears, usually by 4-6 months of age), ultrasonography is the investigation of choice for Developmental Dysplasia of the Hip (DDH). However, in a 3-year-old child, the femoral head ossific nucleus is fully ossified, making an anteroposterior radiograph of the pelvis the definitive imaging of choice. Wait, let's re-evaluate: at 3 years of age, ossification is complete, so an AP pelvis radiograph is the primary investigation of choice, not ultrasound. Therefore, option A is correct.
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