Hip dysplasia: what it is, signs, diagnosis and treatment

This is one of the first signs in newborns. When changing diapers, parents may notice that one leg opens less than the other, or a difference when the baby’s hip bends. This asymmetry should always be analysed by a healthcare professional.

The creases on the back of the thighs or buttocks may appear uneven or vary in number from one leg to the other. Although this is not a conclusive sign, it may indicate a deviation in the position of the hip joint.

During the physical exam, sounds can be heard when moving the baby’s legs.  Usually, these superficial “clicks” or “pops” are normal and occur when tendons slide over bony prominences. A more pronounced sound may indicate hip dislocation and require medical assessment.

In cases of moderate or severe hip dysplasia, one leg may appear shorter than the other. This sign tends to become more evident as the baby grows.

In children, untreated hip dysplasia can lead to late walking or an unsteady gait. Claudication (limping) or waddling is common without the child expressing pain in the early stages.

In adolescents and young adults, hip dysplasia can be manifested through hip pain, especially following physical strain, such as climbing stairs or walking long distances. This pain is usually felt in the groin, and may extend to the thigh or knee, which often leads to misdiagnoses.

This is the preferred treatment in the first months of life. The brace keeps the infant’s legs bent and spread apart, allowing correct hip placement and normal development of the acetabular cavity. This method is effective in over 90% of mild to moderate cases, and is ideal to correct dysplasia in a non-invasive manner.

If the brace is not effective or the diagnosis is late, it may be necessary to apply plaster or splints to maintain the hip in the correct position following hip reduction, which can be performed manually or through surgery.

In cases that are more severe or do not respond to other treatments, surgery may be indicated to reposition the femoral head and correct the joint’s anatomy. Options include periacetabular osteotomy and, in degenerative cases, total hip replacement.

These are crucial steps after any intervention, to help recover mobility, strengthen the hip muscles and avoid future complications.