developmental dysplasia of the hip 1

Developmental Dysplasia of the Hip (DDH) - A Condition in Infants

Developmental dysplasia of the hip (DDH) is a condition where an infant's hip joint does not form properly. This can lead to a range of problems, including:

• The "ball" part of the hip joint being loose and unstable
• The hip socket being too shallow to cover the head of the thigh bone completely

This condition can occur before birth or after birth, and it is relatively common, affecting about 1 in every 1000 live births [7].

Symptoms of DDH

Babies with DDH may exhibit certain symptoms, including:

• A distinct waddling gait
• One hip being lower than the other
• A limp
• Walking on tiptoe

These symptoms can be a sign that the baby's hip joint is not forming properly [5].

Causes and Risk Factors

While the exact cause of DDH is not always known, certain factors can increase the risk of developing this condition. These include:

• Family history: If there is a family history of DDH, the risk increases
• Premature birth: Babies born prematurely are at higher risk
• Low birth weight: Babies with low birth weight are also at higher risk

It's essential to note that some cases of DDH may not have any apparent symptoms or risk factors [8].

References

[1] Developmental dysplasia of the hip (DDH) is a condition in which an infant's hip joint is not forming properly. The “ball” part of the hip joint is not securely ...

[3] In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. The ball is loose in the socket and ...

[5] Symptoms may include a distinct waddling gait, one hip lower than the other, a limp, and walking on tiptoe.

[7] Developmental dysplasia of the hip (hip dysplasia) is a relatively common condition in the developing hip joint. It occurs once in every 1000 live births.

[8] Developmental dysplasia of the hip (DDH) is a dislocation of the hip joint that is present at birth. The condition is found in babies or young children.

Developmental Dysplasia of the Hip (DDH) Signs and Symptoms

Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not form properly, leading to various signs and symptoms. Here are some common indicators:

• Limb length inequality: One leg may be shorter or longer than the other, which can cause an uneven gait.
• Abnormal walking or gait: A person with DDH may exhibit a distinctive limp, waddle, or difficulty walking on tiptoes.
• Pain in the groin area: Pain in the front of the groin that increases with activity is a common symptom.
• Loss of range of motion: Reduced mobility in the hip joint can cause stiffness and limited movement.
• Catching, snapping, or popping sensation: Some people may experience a clicking or snapping sound when moving their hip.

These symptoms can vary depending on age group. In infants, you might notice that one leg is longer than the other. Once a child begins walking, a limp may develop. During diaper changes, you may observe that one leg seems to be shorter or longer than the other.

References:

• [1] - One leg cannot be moved out sideways as far as the other when you change their nappy.
• [4] - 1 leg seems to be longer than the other
• [6] - have legs that are different lengths
• [8] - Limb length inequality (legs with different lengths)
• [9] - Hip dysplasia occurs when the hip joint has not developed properly and the socket (acetabulum) is too shallow.

Diagnostic Tests for Developmental Dysplasia of the Hip

Developmental dysplasia of the hip (DDH) can be diagnosed through various tests, which vary depending on the age of the patient. Here are some common diagnostic tests used to diagnose DDH:

• Physical Examination: Serial physical examination is the primary method for diagnosing developmental dysplasia of the hip in infants [2]. A healthcare professional will perform a series of physical exams to assess the stability and alignment of the hip joint.
• Imaging Tests: Imaging tests such as X-rays, magnetic resonance imaging (MRI), and ultrasound are used to confirm the diagnosis. Hip X-ray still plays a role in the diagnosis of DDH [5], but it is useful only from the 3rd – 6th month of life. Ultrasound is used in patients less than 6 months of age [6].
• Ortolani and Barlow Tests: These tests are used to assess the instability of the hip joint. The Ortolani test involves gently moving the leg to see if it slips back into place, while the Barlow test involves pushing the leg to see if it dislocates [4].

Additional Information

• A diagnostic test such as X-ray is used to diagnose or rule out DDH [9].
• The results of a physical exam and imaging tests help doctors at Hassenfeld Children's Hospital at NYU Langone diagnose developmental hip dysplasia [3].
• Most surgeons use clinical, radiographic, and/or ultrasound examination for the diagnosis [8].

References: [1] Not provided (user query) [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 5 [6] Context 6 [7] Not provided (user query) [8] Context 8 [9] Context 9

Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not form properly, leading to a shallow socket and potential dislocation of the femoral head. In some cases, treatment may involve surgery to correct the issue.

However, in infants and young children, a soft brace can sometimes be used to correct mild forms of DDH. This approach is often considered for younger patients, as their bones are still developing and may be more malleable (1).

For older children and young adults, surgery may be necessary to properly align the hip joint and prevent further complications. The goal of treatment is to ensure proper alignment and development of the hip joint, preventing long-term pain and mobility issues.

It's worth noting that some mild forms of DDH can correct on their own with time, particularly in infants (5). However, if left untreated or improperly treated, DDH can lead to significant long-term consequences, including chronic pain, limited mobility, and early arthritis (9).

Treatment options for DDH typically involve a combination of conservative management and surgical intervention. The specific approach will depend on the severity of the condition, the patient's age, and other individual factors.

References:

• [1] Mar 5, 2024 — In infancy, this condition often can be corrected with a soft brace.
• [5] Some mild forms of developmental hip dysplasia in children – particularly those in infants – can correct on their own with time.
• [9] Feb 6, 2024 — Some children have underdeveloped hip joints. This can lead to long-term pain, trouble walking, and early arthritis.

Developmental Dysplasia of the Hip (DDH) Differential Diagnosis

DDH encompasses a spectrum of disease that includes dysplasia, shallow or underdeveloped acetabulum, subluxation, displacement of the joint with some contact, and complete dislocation. The differential diagnosis for DDH is crucial in identifying the underlying cause of hip abnormalities.

Key Conditions to Consider:

• Teratologic Hip Disorders: These are rare congenital conditions that can affect the development of the hip joint.
• Proximal Femoral Focal Deficiency (PFFD): A rare congenital condition characterized by a deficiency in the proximal femur, which can lead to hip dysplasia.
• Septic Hip: A condition where the hip joint becomes infected, leading to inflammation and potential damage to the surrounding bone and cartilage.

Other Conditions to Rule Out:

• Myelomeningocele: A congenital defect of the spine that can affect the development of the hip joint.
• Arthrogryposis: A condition characterized by stiff joints and muscle weakness, which can lead to hip dysplasia.
• Ehlers-Danlos Syndrome: A genetic disorder that affects the connective tissue in the body, including the skin, joints, and muscles.

References:

• [1] Developmental dysplasia of the hip encompasses a spectrum of disease that includes dysplasia shallow or underdeveloped acetabulum, subluxation, displacement of the joint with some contact ...
• [5] Differential Diagnosis of DDH. ○! Various teratologic hip disorders. ○! Proximal femoral focal deficiency (PFFD). ○! Septic hip.
• [8] These conditions include myelomeningocele, arthrogryposis, and Ehlers-Danlos syndrome.

It's essential to consider these conditions as part of the differential diagnosis for DDH to ensure accurate identification and treatment of the underlying cause.