A female with H/o oligohydramnios during her pregnancy, brings her newborn baby to OPD, on noticing asymmetric thigh folds in her child. The examiner performs flexion, IR and abduction, which produces a click sound. Which is the test done by the examiner?
**Core Concept**
The underlying principle being tested here is the assessment of hip dysplasia or dislocation in newborns, which is often associated with oligohydramnios during pregnancy. The clinical examination aims to detect the presence of a hip instability or dislocation.
**Why the Correct Answer is Right**
The Oolani test, also known as the Ortolani test, is a clinical examination maneuver used to detect hip dysplasia or dislocation in newborns. When the examiner performs flexion, internal rotation, and abduction of the hip, a click sound is produced if the hip is dislocated or subluxable. This click sound is due to the reduction of the dislocated or subluxated femoral head into the acetabulum. The test is performed by gently flexing the hip to 90 degrees, then internally rotating and abducting the hip, which can reduce a dislocated or subluxated hip and produce a palpable click.
**Why Each Wrong Option is Incorrect**
**Option B:** The Von Rosen test is used to assess hip dysplasia in older children, not newborns. It involves flexion, abduction, and external rotation of the hip, which is not relevant to this scenario.
**Option C:** Mc Murray's test is used to assess hip instability in older children and adults, not newborns. It involves flexion, abduction, and external rotation of the hip, which is not relevant to this scenario.
**Option D:** Barlow's test is used to assess hip instability in newborns, but it involves a different maneuver. The examiner attempts to dislocate the hip by applying a gentle downward pressure on the femur while maintaining the hip in flexion and abduction. A positive test is indicated by a palpable click or a feeling of instability.
**Clinical Pearl / High-Yield Fact**
A positive Oolani test in a newborn is a strong indicator of hip dysplasia or dislocation, which requires prompt treatment to prevent long-term complications. It is essential to perform the Oolani test in all newborns with a history of oligohydramnios during pregnancy.
**✓ Correct Answer: A. Oolani test**