Developmental pediatric dysplasia of the hip, or hip dysplasia, is the term used to describe a broad spectrum of abnormalities of the hip joint that may develop around the time of birth or during childhood.
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In the healthy hip joint, the upper end of the femur (thigh bone) meets the acetabulum to fit together like a ball and cup, in which the ball rotates freely in the cup. Cartilage, a smooth protective tissue, lines the bones and reduces friction between the surfaces during movement. In developmental hip dysplasia, however, one or more of these functions work incorrectly.
The conditions encompassed by the term “hip dysplasia” include:
Genetics plays a strong role in the incidence of hip dysplasia. The risk of hip dislocation at birth is approximately one in one thousand. If a parent experienced hip dysplasia during childhood, the risk of his or her own child developing it increases by 12% compared with a parent with no history of the condition. A child whose sibling has hip dysplasia will have a 6% higher chance of developing the condition. Even among children who have no hereditary link, there is a greater risk in all first-borns.
Other pregnancy and birth influences include:
Other factors: Hip dysplasia is much more common in girls than in boys and more frequently affects the left hip than the right. About 80% of cases follow this pattern. The condition can, however, be present in both hips.
“With hip dysplasia, it is important to see a pediatric orthopedic physician early while the child is still young and growing. Non-operative treatments have high success rates in the very young. Delaying the treatment could turn a potentially small surgery into a big surgery. Some things are better treated early while growth potential is still possible.” Shyam Kishan, M.D.
When developmental hip dysplasia is present at birth, the abnormality may be detected during a routine physical examination of the newborn. During this examination, the physician gently flexes the child’s hips in different directions. If the hip is unstable, the doctor she may feel a “clunk” as the hip moves out of alignment.
In a smaller percentage of cases, the problem does not become apparent until later in infancy or early childhood. Later diagnosis of hip dysplasia may be detected during routine examinations of hip stability in the pediatrician’s office. Signs that may bring undiagnosed developmental hip dysplasia to the attention of parent and physician include:
To confirm a diagnosis of developmental hip dysplasia in children up to 4-6 months of age, the orthopedist uses a diagnostic ultrasound scan, also called a sonograph. This technology offers a significant advantage over conventional X-ray exam because images may be taken with the hip in motion and has no risk of radiation. In order to ensure proper development of the bones that make up the hip joint, early intervention is essential.
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