–Examine newborn and continue periodic surveillance physical exam for DDH including length discrepancy, asymmetric thigh or buttock creases, performing Ortolani test, and observing for limited abduction.
–Selective ultrasonography for “high-risk” infants 6 wk to 6 mo of age: history of breech presentation, family history, parenteral concern, history of clinical hip instability on exam, or history of lower extremity swaddling.
–Radiography can be considered after 4 mo of age in high-risk infants without physical exam findings or any child with positive physical exam findings.
–Indication for orthopedic referral: unstable or dislocated hip in physical exam. Referral does not require any prior imaging.