Hip Dysplasia – why it’s important to get a baby checked

Why is it so important to get your baby’s hips checked?

One of the key reasons to get your baby checked is that, due to us living through a pandemic, Australia has been in and out of lockdowns, in particular Melbourne – who is in the running for a podium finish for the longest duration in a lock down state!  With this disruption to normal life, we notice that there is a change to the normal attendance rates for parents visiting their child’s health nurse.

Parents are no longer attending routine assessments, and video conference calls do not seem appropriately equipped to be able to handle the assessment of a child’s hips. Yes, we can look at thigh crease asymmetry, but this is an incredibly unreliable indicator for potential hip problems.1 

In Victoria, our child health nurse assessments occur on a regular basis, at 2, 4, and 8 weeks of age, and then again at four months of age, before there is a bit of a gap until eight months of age. While the vast majority of hip cases undetected prior to three months of age,2 recent literature has indicated a concerning upward trend with the numbers more than tripling over a period of 15 years.3,4 

So why are your baby’s hips getting checked?

The biggest reason is a condition called hip dysplasia (Developmental Dysplasia of the Hip – DDH), and this occurs when the thigh bone and the pelvis are not in proper alignment.

Now this may be because it is dislocated, but it could even be a simple case of a slight dislocation, also known as a subluxation, that can trigger off some of the changes seen in hip dysplasia.

Left in the incorrect position for too long a period of time, the body starts adapting to these new positions and it changes the shape of the bone as it is developing and unfortunately, if left unchecked, this can result in permanent changes or even the early onset of arthritic changes.

This is why it’s so important to detect and manage at an early stage. When detected early the common management option is to use a harnessing system to help hold your child’s hips in a position that will help promote hip development.5 This is ideally done prior to six months of age, as after this stage the bones of our hip are starting to turn to bone instead of being cartilage, and it makes things a little slower or trickier.

So how then can you tell if your child may be at risk for developing this hip dysplasia?

There are certain risk factors for the development of this condition.6 The big four are: 

  • being female, 
  • a first born, 
  • having a family history, and 
  • being in a breached position 

If you tick three of these boxes, your child gets flagged and put on a higher vigilance pathway for monitoring hip growth and development. But you know what, even then cases can still get missed. If you live in a rural location for instance, or even if you were discharged from hospital within four days of giving birth, these are considered risk factors for the development of hip dysplasia.

So what is the best thing to do?

In this article I’m talking more so about the ages of under 12 months. After this age, management, assessing and even how they present change quite substantially, so you really want to have any potential DDH picked up prior to this stage. 

And what is the best way to do that? 

Get your child checked. 

It can be tricky with all that is going on in the world at this point in time but taking the time for an appointment with your health professional to get this condition screened may keep them running better in the future.

  1. Anderton MJ, Hastie GR, Paton RW. The positive predictive value of asymmetrical skin creases in the diagnosis of pathological developmental dysplasia of the hip. Bone Jt J. 2018;100B(5):675-679. doi:10.1302/0301-620X.100B5.BJJ-2017-0994.R2
  2. Williams N. Improving early detection of developmental dysplasia of the hip through general practitioner assessment and surveillance. Aust J Gen Pract. 2018;47(9):615-619.
  3. Williams N, Foster BK, Cundy PJ. Is swaddling damaging our babies’ hips? Med J Aust. 2012;197(5):272. doi:10.5694/mja12.10652
  4. Studer K, Williams N, Antoniou G, et al. Increase in late diagnosed developmental dysplasia of the hip in South Australia: Risk factors, proposed solutions. Med J Aust. 2016;204(6):240.e1-240.e6. doi:10.5694/mja15.01082
  5. Young J, Anderson M, O’Connor C, Kazley J, Mantica A, Dutt V. Team Approach: Developmental Dysplasia of the Hip. JBJS Rev. 2020;8(9):e2000030. doi:10.2106/JBJS.RVW.20.00030
  6. Fludder CJ, Keil BG. Routine screening for developmental dysplasia of the hip by chiropractors: A case report of late diagnosis in an infant. J Can Chiropr Assoc. 2020;64(2):144-154

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