Infant Diagnosis

How is hip dysplasia diagnosed?

Doctors use a combination of physical exams and imaging such as ultrasound or x-rays to diagnose hip dysplasia. Standard practice in the developed world is to do hip exams for newborns and babies for hip dysplasia at well-baby checkups.

Babies are at increased risk for hip dysplasia in the following situations:

  • The baby is a twin or multiple, or was in a breech position at birth.
  • There is a family history of hip dysplasia.
  • The doctor is concerned about the results of the physical exam.
  • There are signs and symptoms of a possible hip problem, such as a limp in a child of walking age.

The American Academy of Pediatrics recommends an ultrasound study at six weeks of age for almost all baby girls who were in the breech, or bottom-first position. Babies with other risk factors may also benefit from an ultrasound, especially when the pediatrician has any concerns about the examination of the hips. An x-ray at four months of age or older is sometimes recommended.

Hip dysplasia can be difficult to diagnose, especially if it is bilateral (both hips are affected) because the hips are symmetrical. The hips could be a little loose, but otherwise fine, and then get progressively worse as the baby gets older, especially if they slip farther out of the socket when the baby is relaxed, such as while sleeping. When both hips are dislocated, the exam is symmetrical.

When a baby with dislocated hips walks, he or she has a waddling gait that is a little more exaggerated than a normal toddler gait. If only one hip is affected, it is easier to spot the affected hip because it can be compared to the other hip. In some cases, hip dislocations have developed in older babies even when the infant exam was normal and the ultrasound was normal at six weeks of age. The cause of these late developing cases is unknown.


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