What is Hip Dysplasia?

What is Hip Dysplasia?

Developmental Dysplasia of the Hip (DDH) or Hip Dysplasia is the abnormal development of the hip joint in early childhood. The condition can range from a mild case (loose hip joint) to a serious case (dislocated hip joint). In most cases it is diagnosed in the first few weeks of life. Treatment is usually very successful. However if not diagnosed and treated at a young age it can become more difficult to treat and can result in invasive treatment such as surgery.

Source: International Hip Dysplasia Institute

For more information please visit these helpful websites:

International Hip Dysplasia Institute About Hip Dysplasia

International Hip Dysplasia Institute Causes of Hip Dysplasia

Royal Childrens Hospital

Raising Children Network

Steps Charity UK

Stanford Childrens Health

VPON Hip Dysplasia Fact Sheet

Hospital for Special Surgery- DDH in adolescents and young adults

Diagnosing Hip Dysplasia

A physical examination of your baby’s hips is usually performed in the first few days after birth, and at every maternal health appointment up until your child’s first birthday. There are two types of manual (physical) tests for detecting hip dysplasia. These are named the Ortolani and Barlow methods.

The Ortolani method is said help identify a dislocated hip that can be reduced back into the socket (acetabulum). The Barlow method can help identify when a hip joint is loose and can be gently pushed out of the hip socket. Although these tests are carried out many times within the first twelve months of a child’s life, it has been stated that the Ortolani and Barlow methods are most reliable in the first 8 weeks of life (http://raisingchildren.net.au/articles/hip_dysplasia.html).

Source: Ortho Pediatrics

For infants two months an older, physical signs are generally more helpful in identifying hip dysplasia. The Galeazzi sign (as pictured below) can be helpful in recognising a difference in knee height (asymmetry), which can indicate a dislocation.

Source: Ortho Pediatrics

Some other physical signs that can be used to identify hip dysplasia include:

  • Leg turning outward on affected side
  • Limited range of movement (decreased hip abduction)
  • Asymmetric thigh or gluteal creases/folds
  • Difference in leg lengths. In a walking child, this could prevent as a limp

If there are concerns at any age further screening should be requested. Ultrasounds are generally performed on babies (generally 4-6 weeks of age) up until the age of approximately six months. If your child passes a physical exam yet presents with risk factors for hip dysplasia they should be referred for ultrasound screening. After six months of age x-rays are more reliable in diagnosing hip dysplasia due to ossification (hardening of the bones).

**Please note that Hip Dysplasia can develop over time. This is why examinations should be performed by a health nurse/GP at subsequent visits. Once Hip dysplasia has been diagnosed, treatment should be sought immediately. The earlier the diagnosis, the easier to treat!

Common Risk Factors of Hip Dysplasia

The exact cause of hip dysplasia is not known however there are some risk factors that are known to contribute to the risk of developing hip dysplasia. Common risk factors of hip dysplasia include:

  • A family history
  • First born girls
  • Breech babies
  • Tightly swaddled babies
  • The hormone relaxin being passed from mother to baby during pregnancy/birth
  • High birth weight (4kg+)
  • Babies born with a foot deformity, stiff neck (torticollis) and congenital disorders

**Please keep in mind that a child can still be diagnosed with hip dysplasia even if they do not have any of the above risk factors.

Common Signs and Symptoms of Hip Dysplasia

  • Click or clunk during hip examination
  • Uneven leg creases
  • Limited range of movement/stiff hip joint
  • Difference in leg lengths
  • Crooked buttock crease
  • Exaggerated limp
  • Dragging of leg whilst crawling
  • Knee(s) turning outwards

Many websites suggest to try and avoid the following in regards to Hip Dysplasia:

  • Moulded baby seats
  • Narrow seated/crotch baby carriers
  • Door frame hanging bouncer
  • Manufactured sleep swaddles that restricts the hips and legs
The above products can force your babys hips into an unhealthy position e.g. legs extended with the hips and knees straight/legs brought together. The IHDI states that the healthiest position for a babys legs to be is with the hips spread naturally out to the side (hips and knees bent) and the thighs supported. For more detailed information, please head to the IHDIs website.
Hip Dysplasia is also known as Congenital hip dysplasia, DDH, Developmental dysplasia of the hip, clicky hips, Infant hip dysplasia, hip dislocation, Acetabular dysplasia and Developmental hip dislocation.