Developmental dysplasia of the hip (DDH) refers to a spectrum of disease ranging from underdevelopment of the socket of the hip joint to complete dislocation of the hip joint. It is a frequently occurring problem in newborn babies, with 1-2 in every 1000 babies being affected. Without appropriate treatment DDH can lead to hip problems in adolescence and early arthritis of the hip. These hip conditions result in pain and limitation of movement, with some cases requiring early joint replacement. However, DDH can be treated to allow normal hip joint development. If identified early the vast majority of babies can be treated with bracing, avoiding the need for surgery.
All newborns should be screened for DDH by identifying risk factors such as breech presentation, family history of hip problems, low amniotic fluid levels or twin pregnancies. A thorough physical examination including hip movements and stability of the hip joint will be performed. Babies with hips that are dislocated at birth will usually be identified through this process.
The difficulty is in identifying babies with underdevelopment of the socket of the hip joint alone, without dislocation, as often the physical examination will be near to normal. This is where ultrasound screening of the hip has found its place as a safe, radiation free, non-invasive and simple test. Ultrasound scanning allows us to identify these babies with DDH and monitor the progress of treatment if needed.
Access to ultrasound screening varies worldwide with some countries universally screening all newborns, others screening only those with risk factors for dysplasia and other places choosing to only ultrasound those babies with abnormal physical examination findings. In Australia there is currently no formalized screening program for DDH.
I am pleased to be able to offer an ultrasound screening service for DDH. Having trained extensively in the use of ultrasound in the diagnosis and treatment of developmental dysplasia of the hip I am happy to discuss this and answer any questions you may have.
Written by Dr Andrew Morris – Orthopaedic surgeon.