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Repeat Hip Exam Needed in Young Children

Infants seen at birth and for early well-child checks are screened for hip problems. Developmental dysplasia of the hip (DDH) is the most common problem. DDH is a shallow hip socket. It can be mild with flattening of the hip joint, or it can be severe enough to cause hip dislocation.

Until recently, children who developed DDH later in childhood were assumed to have DDH at birth that was missed in screening (or not screened at all). In this study five cases of late developing DDH point to the possibility that something else is going on.

All five cases were born with normal hip anatomy. X-rays were taken with no sign of instability or dislocation. Three of the children had a positive family history for DDH. Only one patient had a positive sign of hip dislocation early (three months). The rest were not diagnosed until the child started to walk with a limp.

Other studies have also reported similar findings. The authors conclude that missed cases of DDH may not be missed at all but late in developing. They advise that all newborns have repeated exams during the first year of life for hip instability. Any child with a family history of DDH should be followed until they walk. Ultrasound can be used to confirm the diagnosis when DDH is suspected.

References: Alfredo Raimann, MD, et al. Late Developmental Dislocation of the Hip After Initial Normal Evaluation. In Journal of Pediatric Orthopaedics. January/February 2007. Vol. 27. No. 1. Pp. 32-36.

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