Developmental dysplasia of the hip can present as an acute limp if it is missed in earlier infancy. Suggestive features are the presence of an ‘odd gait’ for some time; there is usually a leg length difference and limited hip abduction. Risk factors can be determined from the parents. A radiograph of the pelvis is usually diagnostic – figure below. Urgent out-patient consultation with a paediatric orthopaedic specialist is necessary.