Orthopedics at My Medyk

Diagnosis and treatment of hip joints in infants

Diagnosis and treatment of hip joints in infants

First six weeks of an infant lifes are crucial.

Each infant, after his first six weeks , should see an orthopaedist in order to have his hip joints looked at and assessed for some children are born with their joints not fully developed. On average, one in twenty children has got hip dysplasia. Although a child would have to lie in bed for a few months, it is already possible to diagnose and successfully treat abnormalities that, in the future, could affect proper motility. 

In order to understand better what hip dysplasia is, try imaging the way hips are built. Take one hand and clench it into a fist  and cover it with your other hand. Then begin moving your fist, making sure that your hand never stops covering it. The fist indicates head of the femur, and your hand is the acetabulum (concave surface of the pelvis). Although head of the femur moves in different ways, its surface stays in touch with the acetabulum's surface at all times. When the acetabulum is too shallow or too steep, and head of the femur doesn't fit properly, that's when hip dysplasia occurs. This defect might affect one or both hip joints. The joint, in that case, cannot evolve properly, and moreover it is likely to dislocate, which happens when the acetabulum loses connection with head of the femur. 

What causes hip joint dysplasia?

Hip joint dysplasia is more common to occur in girls, multiple pregnancies and breech births. Children with this defect are usually born in families who already have history of it in the past, e.g. in parents or siblings.  The reason could also be an improper position of the baby in mother's womb due to, for example, oligohydramnios, transverse lie or higher weight. It is extremely important to diagnose such defects as early as possible, thanks to which treatment of hip dysplasia will be shorter and less severe.

Visit a doctor when your child:

  • seems like he can't spread his legs to the sides,
  • positions his legs in an uneven , unnatural way,
  • cries when you touch or move his legs and you feel resistance while moving them,
  • seems to have one leg longer than the other,
  • looks like the folds between his buttocks and thighs are uneven

Remember! Uneven gluteal folds (between thighs and buttocks) do not necessarilymean the baby has got hip dysplasia. Those can sometimes be asymmetric even in healthy babies. However, if you notice such irregularity, ask for a medical advice, just to be safe. 

First hip joint examination 

After the child is born in the hospital, the neonatologist (infant specialist) should examine your baby's joints. It is the first ever joint exam in your child's life (ask the doctor to make sure it was performed before the hospital discharges you), but you're the one who has to ensure he gets
another one. It should be done after first six weeks, no later than in the 12th week of your child's life (though, of course, better late than never).

Orthopaedic hip examination

For the exam the baby must be undressed (that includes the diaper, as well) for the doctor has to assess his locomotor system. He will first take a look at the baby's legs, compare lenght of his thighs and the symmetry of gluteal folds. He will also check the ability of baby's legs to spread sideways (which resembles the ・rog-leg・ position). This exam is not unpleasant for the baby and it does not hurt. If the baby's crying during the examination, it is because he might be hungry or cold. 

Ultrasound of hip joints

The doctor will refer your baby for a scan. Every child should have it done because it allows to detect any potential irregularities that cannot be discovered during a general check-up. The scan is one hundred percent safe for the baby. It isn't painful. The child doesn't have to be specially prepared for this exam. The baby has to lie on his side, while the doctor is moving the small probe across the skin on his hips. The examination lasts a couple of minutes. 
If your child's doctor doesn't refer you for the hips scan, ask why. If it cannot be done for some reason, it is better to invest and have it done privately.  While scheduling an appointment, ask if the doctor who will be performing the ultrasound has a valid certificate and was the sonographic instrument checked within the last five years. You should not be afraid or ashamed to ask such questions because meeting those requirements guarantees good quality of the exam which is exactly what your child's health depends on. 

All of the specialist at My Medyk Dental & Medical Centre are certificated specialists and our medical equipment is regularly checked to ensure our patients are provided with highest quality possible. You can schedule a visit with our orthopedist for both, regular examination and an ultrasound scan at the same visit.