Congenital Hip Dislocation - Abnormal Gait in my Baby

Dear Ask The Doctor: I'm 28 years old, mother of a male baby, he is 14 months now, he starts to walk with support then i noticed that his right leg shows marked lateral rotation of the foot i can't evaluate whether the rotation in the ankle, knee or hip level. is this normal development? or what is the deferential diagnosis? and what investigations i need to reach an accurate diagnosis?

Dear Marian: This does not seem to be a normal development and in my opinion, the lateral or external rotation of his right leg could be due to the congenital dislocation of hip, also known as dysplasia of the hip. Clinical examination by your baby’s pediatrician may help diagnose the condition. Ultrasound of the hip is the investigation of choice for confirmation. Differential diagnosis include coxa varum, congenital short femur or septic dislocation of hip.