Hip Dysplasia

The hip joint is comprised of a ball (femoral head) and socket (acetabulum). During development, the acetabulum may fail to fully form, resulting in an abnormally shallow socket. This shallow socket does not fully cover the femoral head, leading to feelings of hip instability and progressive hip pain. Over time, hip dysplasia can damage the labrum that lines the socket and lead to degeneration of the articular cartilage that covers the ball and socket, leading hips with dysplasia to wear out faster than hips without dysplasia.

What are the symptoms of hip dysplasia?

While hip dysplasia is present at birth, symptoms may present at different stages of life. In general, the more severe the dysplasia, the earlier it presents with pain and activity limitation. When a child is born, the pediatrician tests for the presence of hip dysplasia. Severe cases may present with unequal leg lengths, limited range of motion that may be noticeable during diaper changes, and the development of a limp when the child begins to walk.

In less severe cases of dysplasia, symptoms may not present until young adulthood. In these cases, hip dysplasia may cause tearing of the labrum and the early onset of hip osteoarthritis. These will present with new onset activity-related groin pain and, in severe cases, a sensation of hip instability and/or dislocation may be present.

Who has hip dysplasia?

Hip dysplasia is primarily a congenital condition, present from birth, and affects approximately 1 in 10,000 babies. There are a number of factors that increase the risk of a baby developing hip dysplasia. Hip dysplasia can originate in the womb due to increased pressure on the hips during fetal development. Factors such as a first pregnancy, the delivery of a large baby, and a breech position (abnormal positioning of the baby in the womb) contribute to reduced space and heightened pressure on the developing hips.  In addition to developmental factors, hip dysplasia may have a genetic component. The condition can be inherited, passed down through families and is more common in females.

How is hip dysplasia diagnosed?

Hip dysplasia diagnosis starts with infancy screenings conducted during well-baby visits. A specialized physical exam maneuver involves moving the hip to assess the proper fit of the ball within the socket. Early detection at this stage is crucial for effective intervention.

For infants older than 6 months, confirming the diagnosis often necessitates advanced imaging techniques. X-rays, ultrasound, or CT scans provide detailed insights into the alignment of the hip joint, aiding in the precise diagnosis of hip dysplasia.

Diagnosing mild cases of hip dysplasia in infancy can be challenging with the physical exam alone. In such instances, diagnosis may be delayed until young adulthood, when symptoms become more pronounced and the hip starts causing progressive pain and dysfunction.

While routine screenings are effective in many cases, mild instances of hip dysplasia may not become apparent until young adulthood or later in life. At this stage, Dr. Shane J. Nho will ask you about your medical history and symptoms. He will also order X-rays that will reveal the presence or absence of dysplasia. Often, advanced imaging, such as an MRI or CT scan, is required to assess for damage to the labrum/cartilage and to assess the overall alignment of the bones.