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Endgames Spot Diagnosis

A girl with an abnormal gait

BMJ 2016; 355 doi: (Published 19 October 2016) Cite this as: BMJ 2016;355:i5216
  1. Yong-Hai Zhou, consultant paediatrician1,
  2. Ming-Hua Zheng, consultant hepatologist2
  1. 1Department of Paediatrics, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
  2. 2Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
  1. Correspondence to: M-H Zheng zhengmh{at}

A 1 year old girl presented to the paediatric orthopaedic clinic with abnormal gait. Her parents noticed that she had a “duck-like” waddle when she had first started to walk a month previously. On examination, there were asymmetrical skin creases on her buttocks, and her legs were of similar length. There were no other external congenital malformations. Anteroposterior radiography of the infant’s pelvis was carried out (fig 1). What is the diagnosis?

Fig 1


Bilateral developmental dysplasia of the hip.


The image shows changes typical of developmental dysplasia of the hip (DDH). …

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