Overview
Hip dysplasia is a medical condition where the hip socket doesn't fully cover the ball portion of the upper thighbone, allowing the hip joint to partially or completely dislocate. This can lead to joint instability and, in some cases, osteoarthritis. Hip dysplasia can be present at birth or develop later in life, often due to genetic factors or certain activities. Early diagnosis and treatment can help manage symptoms and prevent further complications.
Understanding the disease
Symptoms
Symptoms of hip dysplasia can vary depending on the age group. In infants, signs may include one leg being longer than the other, a limp during walking, or reduced hip flexibility during diaper changes. In teenagers and young adults, hip dysplasia can cause painful complications such as osteoarthritis, hip labral tears, and activity-related groin pain. In some cases, there may be a sensation of instability in the hip.
Risk Factors
Risk factors for developing hip dysplasia include being born with the condition, family history, being a girl, and being born in the breech position. Other factors that may play a role in developing hip dysplasia include being a first-time mother, having a large baby, and being swaddled tightly with the hips and knees straight.
Development
Hip dysplasia can develop due to a shallow hip socket that doesn't fully cover the ball portion of the thighbone. This condition can be present at birth or develop later in life. Factors that can contribute to hip dysplasia include:
- Genetics: Hip dysplasia tends to run in families, and the risk is higher in girls.
- Birth factors: Crowding in the womb during the final month of pregnancy can lead to hip dysplasia. Factors that can contribute to this include a first pregnancy, a large baby, or breech presentation.
- Infant lifestyle: Hip dysplasia can also develop in babies who are swaddled tightly with their hips and knees held straight.
- Age: Milder cases of hip dysplasia might not cause symptoms until a person is a teenager or young adult. At this stage, hip dysplasia can damage the cartilage lining the joint and the soft cartilage surrounding the socket portion of the hip joint. In older children and young adults, hip dysplasia can cause painful complications such as osteoarthritis or a hip labral tear, which may lead to activity-related groin pain or a sensation of instability in the hip.
Assessment and Diagnosis
Triage
If hip dysplasia is suspected in an infant, you should see a doctor for a check-up shortly after birth and during well-baby visits. If it is diagnosed in early infancy, a soft brace can usually correct the problem. If symptoms arise in teenagers or young adults, such as painful complications like osteoarthritis or a hip labral tear, or if you experience activity-related groin pain, sensation of instability, or if you notice a leg length discrepancy, it is advisable to consult a doctor.
Diagnosis
To diagnose hip dysplasia, doctors typically perform physical exams during well-baby visits. They check an infant's legs by moving them into various positions to indicate whether the hip joint fits together well. If your doctor suspects hip dysplasia, they may suggest imaging tests like X-rays or magnetic resonance imaging (MRI). These tests can help confirm the diagnosis and pinpoint the extent of hip damage.
Management and Treatment
Complications
Potential complications of hip dysplasia include damage to the cartilage lining the joint, a hip labral tear, and an increased risk of developing osteoarthritis. In later life, these complications can lead to painful symptoms and reduced joint mobility.
Treatment
Hip dysplasia treatment depends on the age of the affected person and the extent of the hip damage. Infants with mild cases of hip dysplasia may be treated with a soft brace, such as a Pavlik harness, that holds the ball portion of the joint firmly in its socket for several months. This helps the socket mold to the shape of the ball. For older babies, the doctor may move the bones into the proper position and then hold them there for several months with a full-body cast. Sometimes surgery is needed to fit the joint together properly. More severe cases may require a periacetabular osteotomy, where the socket is cut free from the pelvis and then repositioned, or hip replacement surgery for older individuals with severe damage resulting in debilitating arthritis.