What is the recommended management for a child who has a palpable clunk during hip dysplasia screening?

The recommended management for a child who exhibits a palpable clunk during hip dysplasia screening is referral to an orthopedic surgeon. This palpable clunk is indicative of a hip that is dislocatable, and it suggests that the child may have developmental dysplasia of the hip (DDH).

In such cases, early intervention is crucial to prevent potential long-term complications, such as hip osteoarthritis and impaired mobility. An orthopedic surgeon will typically conduct a thorough evaluation, which may include imaging studies, to confirm the diagnosis and determine the appropriate course of action. The treatment could involve a range of options depending on the severity of the dysplasia and the child’s age, including the use of a Pavlik harness or, in more severe cases, surgical intervention.

Observation and follow-up would not be appropriate in this situation because the presence of a palpable clunk signals a need for more proactive management rather than merely monitoring for changes over time. Immediate surgical intervention is generally not the first step unless there are severe complications or risks that warrant it without further evaluation. Physical therapy may ultimately be necessary as part of the treatment plan, but it is not the immediate management for a child with a palpable clunk. Therefore, the correct choice emphasizes the importance of specialized evaluation and management