Rosh Pediatrics Practice Exam

What is the most appropriate intervention for a 4-week-old girl with hip dysplasia demonstrated on ultrasound?

1. AApplication of a Pavlik harness

2. BObservation and repeat ultrasound in four weeks

3. CObtain X-rays of the pelvis

4. DTriple diapering

The correct answer is: AApplication of a Pavlik harness

The most appropriate intervention for a 4-week-old girl with hip dysplasia demonstrated on ultrasound is the application of a Pavlik harness. This device is designed to maintain the hip joint in a position that promotes proper development and stability, particularly in infants diagnosed with developmental dysplasia of the hip (DDH). The Pavlik harness works by positioning the legs in a flexed and abducted position, which allows for optimal coverage of the femoral head by the acetabulum and encourages normal development of the hip joint. Early intervention is critical; by targeting treatment during the first few months of life, the likelihood of correcting the condition and preventing potential complications, such as hip dislocation or the need for surgical intervention later, is significantly improved. In contrast, other options may not provide the immediate support required for effective management of hip dysplasia in a young infant. Observation with a repeat ultrasound, while sometimes a consideration in mild cases, is not appropriate when there is clear evidence of hip dysplasia needing intervention. Likewise, obtaining X-rays may not be necessary at this age since ultrasound is the preferred imaging modality for assessing the hip in infants. Triple diapering, while it may offer some degree of stabilization, is not a recognized treatment protocol for hip dysplasia and