Patient education: Developmental dysplasia of the hip (The Basics)

What is developmental dysplasia of the hip? — 

This is a condition that causes hip joint problems, mostly in babies and children. The hip joint is a "ball and socket" joint. It's called that because the top of the thigh bone is shaped like a ball and fits into part of the pelvic bone (figure 1).

In developmental dysplasia of the hip, the "socket" part of the joint doesn't form normally. Because of this, the hip joint is too loose. The "ball" part can slip out of the joint too easily. If it slips completely out of the joint, it is called "dislocation."

What are the symptoms of developmental dysplasia of the hip? — 

It usually causes no symptoms in babies. People usually find out their baby has it during a routine exam. Babies are checked for developmental dysplasia of the hip after birth. Doctors and nurses also check for it at routine visits until a child is walking.

Sometimes, people find out their child has developmental dysplasia of the hip when their child has an X-ray of the hip done for another reason.

In toddlers and older children, developmental dysplasia of the hip can cause symptoms. It can make 1 leg look shorter or turned away from the body. It can also cause a child to limp or walk in an uneven way.

Is there a test for developmental dysplasia of the hip? — 

The doctor or nurse will check for it by moving your baby's legs around in the hip joint. They will also make sure both legs look the same and 1 leg does not seem shorter than the other.

The doctor or nurse might also order an X-ray or imaging test, like an ultrasound. These create pictures of the inside of the body.

How is developmental dysplasia of the hip treated? — 

Treatment depends mostly on your child's age.

Babies younger than 4 weeks old aren't always treated right away. That's because a loose hip joint can be normal in newborn babies. It sometimes gets better on its own. If your baby has a loose hip, the doctor or nurse will keep checking it to see if it gets bettor on its own or if it needs treatment.

Treatment for babies 4 weeks to 6 months old usually involves wearing a device to hold the hip joint in place so the bones can grow normally. The device most often used is called a "Pavlik harness" (figure 2). Babies usually wear this for 2 to 3 months.

Treatment for babies and children older than 6 months usually involves a procedure or surgery to put the hip joint bones back in the correct position. Then, your child will need to wear a cast for 3 to 4 months to keep their hip joint in place.

Does developmental dysplasia of the hip cause long-term problems? — 

This depends on different things, including how old your child was when the condition was diagnosed and how severe it was. Many babies with this condition have no long-term hip problems.

Some children, especially those who were diagnosed later in childhood, have hip joint pain or damage later.

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