Purpose or Case Report: To assess the relevance of asymmetrical skin folds as a clinical sign for the diagnosis of developmental dysplasia of the hip (DDH).
Methods & Materials: We have retrospectively reviewed the ultrasound reports of the hip of 249 infants (mean age, 11.7 weeks) (113 males, 136 females) with skin folds asymmetry (gluteal, thigh, or inguinal) either as the only clinical referral, or in the company of other signs or risk factors.
Results: We have found 5 cases of immature or mild hip pathology (all 5, females); in two cases (0,8% of the cases) the skin fold asymmetry was the only clinical referral information. The other three, apart from the asymmetry, had risk factors for DDH (one case, torticollis; two cases, family history). Positive Predictive Value (PPV) for skin folds asymmetry as the only clinical sign, without risk factors: 0.9%.
No case showed subluxation/luxation of the hip. (see Table 1).
Conclusions: Skin folds asymmetry, as the only clinical sign, without risk factors, presents a PPV very low for DDH (specially in male infants: 0 cases). It may not be justified ultrasound screening for these infants.