Infant Hip Dysplasia

Children’s orthopaedic–traumatologist Julija Kociute–Ravinskiene works at our centre and provides infant hip dysplasia diagnosis. It’s important to note that hip ultrasound test is uninvasive and harmless.

What is hip dysplasia?

Hip dysplasia is the failure of the hip joints to develop normally. Hip dysplasia can be divided into three major stages. The first stage is when the head of the femur does not smoothly round the acetabulum. Usually it’s called dysplasia. In Lithuania we don’t have data on how many babies have noticeable dysplasia, however in Western Europe approximately 3% of new-borns have it. We believe that Lithuanian statistic should not differ. If dysplasia is identified in early stage, it is possible to mature the joints to its correct shape. Usually it’s achieved by using conservative treatments. If dysplasia is not treated until the hips are fully developed, they can progress to a complete dislocation of the femur. The second stage of dysplasia is when the acetabulum and femur are not in close contact. The last stage of dysplasia is when the joint is fully dislocated and there is no contact between the acetabulum and femur. The last two stages of dysplasia require complex treatments and surgery operations are quite common.

What are the causes of hip dysplasia?

The cause is not clear. However, there are factors that are known to contribute to the chance of a baby being born with hip dysplasia. It has been observed that kids who have dysplasia in their family history are at a higher risk level. A bigger risk is also faced by those who were born prematurely, by caesarean section or of multiple pregnancies. Also, if an unborn baby is in the breech position or has a congenital foot deformity or spinal stenosis.

What are the symptoms and signs of dysplasia?

Hip dysplasia can be diagnosed by a children doctor orthopaedist. Usually the main symptoms are noticed by GPs and they will send the parents with their child to see an orthopaedist for a hip ultrasound check. The main symptoms which are noticed by your doctor could be: the body may not be equal on both sides and the femur looks shorter on one side. However all of the above mentioned symptoms are indirect signs and therefore it’s important to have a specialist examination.

How is dysplasia of the hip diagnosed?

When dysplasia of the hip is suspected an orthopaedist checks how a new-born is moving his legs and evaluates specific symptoms. After the general inspection a hip ultrasonography is done and if needed – X-ray. In German-speaking countries the general hip inspection with ultrasound scan is mandatory for all new-borns before they are 6 weeks old. In the last 30 years hip surgeries in these countries are very unusual as dysplasia of the hip is diagnosed at early stages. However these mandatory inspections are very expensive. In Lithuania the hip ultrasound scan is done only if the specialist is suspecting for a new-born to have dysplasia. If dysplasia of the hip is diagnosed in early days, it can be treated without surgeries.

When is the best time to check the child for hip dysplasia?

The early diagnosis of hip dysplasia is very important and new-borns can have a hip ultrasound scan from their first days. The ultrasound scan is a painless and inexpensive test. Usually this test is done for a baby up to 4-6 weeks old. The ultrasound scan can also be done for older children, however once a baby is 6-8 months old the femoral head ossification is starting and it becomes harder to evaluate hips anatomy. However if this is the case an X-ray test can be done and is needed.

What should you do if your baby has been diagnosed with hip dysplasia?

Well, first, don’t panic. Off course, it’s not pleasant news, but if it’s diagnosed at an early stage and treated there is a huge opportunity that your kid’s hips will develop well and it won’t have any impact on his/her future life and will not have any impact on walking.

What happens if hip dysplasia is not treated?

If hip dysplasia is not treated a child starts limping, afterwards he/she might feel pain in the hips. Also a hip arthrosis starts developing at an early age. The older the child the more difficult it becomes for a person to move and complex operations are required to treat the disease.