Our baby girl was diagnosed with hip dysplasia at birth. The doctor seems very certain of the diagnosis. We're wondering if an X-ray should be taken to know for sure. What do you advise?

The gold standard test used to screen infants for developmental dysplasia of the hip (DDH) is called Ortolani's maneuver. By carefully examining and testing the hips, the doctor or nurse can accurately identify DDH.

X-rays are not really used in young babies to avoid exposure to the radiation. An ultrasound would be a more likely choice. Ultrasound (US) imaging is not routinely ordered without a reason, though. Almost 80 per cent of any hip abnormalities seen on US disappear by the time the child is six months old. So US testing is not done routinely.

The doctor may consider additional testing if it's indicated. But a competent examiner performing the Ortolani test is usually accurate. You can always ask for a second opinion. The physical exam is less expensive and less invasive for the infant compared with further imaging tests.

US testing is done more often when the physical examination is normal but there are risk factors to consider. Sometimes US is used to monitor the results of conservative treatment.

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