Hip dysplasia symptoms & treatment
Find an ortho specialistHip dysplasia, or developmental dysplasia of the hip (DDH), occurs when your hip joint doesn't form correctly. This issue can affect one or both hips and is usually present from birth.
Our orthopedic specialists at Aurora Health Care are here to help you find relief from hip pain caused by dysplasia. We offer expert knowledge in the latest treatment and diagnostic methods, providing you with a wide range of options to meet your specific needs.
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What is hip dysplasia?
Your hip joints are two of four ball-and-socket joints in your body. The other two are your shoulders. When you have hip dysplasia, the socket is too shallow, causing the thigh bone's ball to slip in and out of its socket. This leads to hip instability and pain and can result in arthritis if left untreated.
Hip dysplasia can appear at any stage of your life. It's most often a congenital condition, meaning it develops at birth or while you’re in your mother's womb. However, hip dysplasia might not be diagnosed until your teenage years or adulthood due to delayed symptom development.
Hip dysplasia in adults
Although hip dysplasia typically starts to develop in newborns, it may not be identified until adulthood. This delay occurs because the symptoms were mild and went unnoticed.
Symptoms of hip dysplasia in adults
Adult hip dysplasia is often diagnosed when you start experiencing hip pain, instability, or early-onset arthritis. Symptoms vary in severity and may include:
- Limping or changes in your walking pattern
- Difficulty with activities that require hip movement, like running or prolonged sitting
- A feeling of hip instability, especially during physical activities
- Clicking or popping sounds in the hip joint
- Persistent pain in the groin, side, or back of the hip
Hip dysplasia in babies
Hip dysplasia in babies may be noticed in the womb or during the first few months of life. Early detection is crucial for successful treatment.
Several factors contribute to hip dysplasia, such as the baby's position in the womb and genetic influences. The condition can also progress as the baby grows, particularly if certain risk factors are present.
Symptoms of hip dysplasia in babies
Early recognition of hip dysplasia symptoms is essential for effective treatment. Look for these signs in your baby:
- Asymmetrical skin folds: Extra skin folds on the thigh or buttocks that are not symmetrical
- Clicking or popping sounds: Audible or felt clicks or pops when moving the baby’s hip
- Hip instability: The hip may feel unstable or slip in and out of place
- Limited range of motion: Difficulty moving one leg outward as easily as the other
- Uneven leg lengths: One leg may appear shorter
Recognizing and treating hip dysplasia early is essential to getting the proper treatment. If left untreated, it can lead to early arthritis.
Causes of hip dysplasia
Hip dysplasia is influenced by various factors, including genetics and environmental conditions. Here are some common causes:
- Swaddling practices: Tightly swaddling babies with straight legs can restrict normal hip movement, raising the risk.
- Position in the womb: Breech babies, positioned feet down, are at higher risk.
- Family history: If a family member has hip dysplasia, your risk increases.
Women, or those assigned female at birth, are more prone to hip dysplasia than men. This is largely due to hormonal differences.
During pregnancy, the hormone relaxin is produced to loosen the pelvic ligaments for childbirth. This hormone can also affect infants, making their hip joints more vulnerable to instability and dysplasia.
Diagnosing hip dysplasia
Diagnosing hip dysplasia involves a physical exam and imaging tests like an MRI, X-rays or ultrasound,
Your doctor may use specific maneuvers for infants they believe have hip dysplasia. These tests, such as the Ortolani and Barlow tests, check for hip instability.
What are the Ortolani and Barlow tests?
In the Ortolani test, the doctor places their hands over your baby's knees with their thumbs on the thighs. They gently spread their legs apart, a movement called abduction.
As the legs are moved, the doctor feels for any clicking or popping in the hip joints. A positive Ortolani sign occurs when a “clunk” indicates the hip is sliding back into the socket, meaning it was out of place and has been moved back in during the test.
The Barlow maneuver involves the doctor holding the baby’s thighs with thumbs on the inside of the knees and fingers on the outside. They gently push the knees together, moving the legs inward toward the body's middle, a movement called adduction. A positive Barlow sign is when the doctor feels a “clunk” or shift, indicating the hip can be dislocated with this maneuver.
Can hip dysplasia be cured?
If detected early, hip dysplasia is easily treatable. While there’s no universal cure, various treatments can greatly improve hip function and reduce your pain.
Getting treatment as soon as possible is crucial, particularly in infants that are still developing, as their bones can be guided into the correct position more easily. Treatment for older children and adults may be more complex but remains highly effective.
Treatment for hip dysplasia
Treatment for hip dysplasia depends on your age and the severity of the condition. Here are some common treatment options:
- Pavlik harness: This soft brace maintains proper hip positioning, promoting normal development in infants. It's typically worn full-time for weeks or months.
- Closed reduction and cast: This treatment is used if the Pavlik harness is not effective in treating hip dysplasia. The doctor gently repositions the hip and applies a body cast to maintain alignment.
- Surgery: Older children and adults may require surgery, ranging from minimally invasive arthroscopy to realign the hip, to more extensive procedures like osteotomy, where hip bones are cut and repositioned. Hip replacement surgery may be recommended in severe cases; however, it is not a common treatment for hip dysplasia.
- Physical therapy: Essential for recovering strength and mobility post-surgery or casting.
Hip pain management is also a big part of treatment. This might include over-the-counter or prescription pain medications. Lifestyle changes such as maintaining a healthy weight and avoiding high-impact activities can also help manage symptoms.
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