MBBS OSCE · Paediatrics
OSCE — Developmental Dysplasia of the Hip
Eight-minute OSCE station on Developmental Dysplasia of the Hip: focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Developmental Dysplasia of the Hip.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Developmental dysplasia of the hip (DDH) is a spectrum of hip joint abnormalities in the infant and child ranging from a lax, dislocatable hip to a frankly dislocated hip with a shallow (dysplastic) acetabulum. Formerly called congenital dislocation of the hip (CDH); renamed because the disorder can develop after birth. Risk factors: breech presentation, female sex, firstborn, oligohydramnios, family history, foot deformity. Newborn: Barlow test (dislocatable) and Ortolani test (reducible clunk). Older infant: limited abduction, asymmetric skin folds, Galeazzi sign. Walker: Trendelenburg gait, leg-length discrepancy. Image with ultrasound under 4 to 6 months, plain X-ray over 4 to 6 months
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Newborn with breech presentation, female sex, firstborn or family history = exam |
| Safety | Positive Ortolani (reducible clunk) in the newborn = dislocated hip; refer urgen |
| Safety | Limited abduction or asymmetric skin folds in an older infant = late-presenting |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.