The Journal of Arthroplasty
Volume 27, Issue 4 , Pages 527-532, April 2012

Variable Expression and Incomplete Penetrance of Developmental Dysplasia of the Hip:

Clinical Challenge in a 71-Member Multigeneration Family

  • George J. Feldman, PhD, DMD

      Affiliations

    • Thomas Jefferson University and the Rothman Institute of Orthopaedics, Philadelphia, Pennsylvania
    • Corresponding Author InformationReprint requests: George Feldman, PhD, DMD, 1015 Walnut St, Curtis Building, Suite 501, Philadelphia, PA 19107.
  • ,
  • Christopher L. Peters, MD

      Affiliations

    • Department of Orthopaedics, University of Utah, University Orthopaedic Center, Salt Lake City, Utah
  • ,
  • Jill A. Erickson, PA-C

      Affiliations

    • Department of Orthopaedics, University of Utah, University Orthopaedic Center, Salt Lake City, Utah
  • ,
  • Bryan A. Hozack, BA

      Affiliations

    • Thomas Jefferson University and the Rothman Institute of Orthopaedics, Philadelphia, Pennsylvania
  • ,
  • Ranna Jaraha

      Affiliations

    • Thomas Jefferson University and the Rothman Institute of Orthopaedics, Philadelphia, Pennsylvania
  • ,
  • Javad Parvizi, MD, FRCS

      Affiliations

    • Thomas Jefferson University and the Rothman Institute of Orthopaedics, Philadelphia, Pennsylvania

Received 12 May 2011; accepted 16 October 2011. published online 19 December 2011.

Abstract 

Developmental dysplasia of the hip is a crippling condition that affects children and adults. Identical twin studies support a strong causative genetic component. Although clinical tests for newborns can detect gross malformations, it is the subtle malformations that are often not detected, resulting in early onset osteoarthritis of the hip in adults. As a first step in identifying the causative mutation, we have recruited the largest documented affected family with 71 members spanning generations. Clinical and radiographic signs of developmental dysplasia of the hip are described, and the diagnostic challenge of identifying affected family members is discussed. Variable expression of disease allele is evident in several members of the family and greatly contributes to the diagnostic challenge facing clinicians.

Keywords: developmental dysplasia of the hip, incomplete penetrance, variable expression

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 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.10.016.

PII: S0883-5403(11)00564-X

doi:10.1016/j.arth.2011.10.016

The Journal of Arthroplasty
Volume 27, Issue 4 , Pages 527-532, April 2012