The hip joint in small babies
Developmental of hip dysplasia is a condition where the ball of the femur and the crater of the pelvis (the socket) in babies don’t properly form. In some cases, this condition can be detected in a physical examination after birth, however in many cases it can be misdiagnosed.
An ultrasound scan of the hip joints can help in detect this important medical condition.
Ultrasound scan of the hip joints in newborns – who’s at risk?
This is an easy and fast scan with no radiation that can be done in many health service centers.
In some countries an ultrasound scan is part of a routine check in all babies in order to detect instability of the hip joints. In other countries it is recommended only for high risk children such as:
• Babies with signs of instability of the hip joints (the examination is done in neonatal wards or in the first baby’s examination).
• In case there is a family history of congenital instability of the hip joint.
• Babies who were born in breech position.
• In cases of amniotic fluid deficiency.
• In multiple births.
• In cases of specific congenital deformation of the feet and knees.
• In cases of deformations in other parts of the body such as torticollis which is inclination of the head and neck to one side. Read more on congenital torticollos here.
What is my recommendation for performing hip ultrasound in all newborns?
From discussions with orthopedic surgeons that specialize in this topic and from my personal experience, there are children with low level of dysplasia which will not be detected in a physical examination. Furthermore, this condition can occur in babies with none of the risk factors mentioned above.
In addition, this developmental problem might not be discovered at birth but will appear later on. Therefore, I recommend to include the specific tests to detect instability of the hip joints in every physical examination performed by a pediatrician up to the age of 12 months (and not just in newborns).
Moreover, my recommendation for parents is to consider to perform an ultrasound scan of the hip joints on every baby, even if there are no risk factors.
When to perform the ultrasounf scan to detect the hip instability?
In case there are signs of instability of the hip joints, the examination should be performed as soon as possible. Otherwise, the ultrasound scan should be carried out when the baby is about 6 weeks (not before the age of 4 weeks).
Since getting an appointment for the scan can take several weeks, I recommend parents to schedule the appointment for the scan for when the baby is 6 weeks old.