Developmental Dysplasia of the Hip

Symptoms

The signs of developmental dysplasia of the hip (DDH) vary depending on whether one or both hips are affected.

A newborn or infant with DDH may have:

• No obvious signs of a defect.
• Extra folds of skin on the inside of the thigh(s). But a newborn without this condition also may have these extra folds.
• Less mobility or flexibility in the movement of the hip joint(s).
• One leg that seems shorter than the other.
• Other physical deformities, especially of the feet.

In rare cases, DDH develops in the first few weeks or months after birth and signs may not be seen until your child starts to walk. Then your child may:

• Stand with one hip raised higher than the other because one leg is shorter than the other. The shorter leg is on the affected side. It seems shorter if the upper end of the thigh bone has slipped up above its normal position in the hip socket.
• Walk on the toes of one foot with the heel up off the floor, attempting to make up for the difference in leg length.
• Walk with a limp (or a waddling gait if both hips are affected).
• Stand with a greater-than-normal inward curve (lordosis) of the lower back (lumbar area) if both hips are affected.

Children with untreated DDH may develop permanent deformities in their hips. Untreated DDH can also lead to hip joint degeneration, which is a sort of early "wearing out" of the socket. When the degeneration occurs in the cartilage that protects and cushions joints, it is known as osteoarthritis. Eventually the bones, which had been separated by the cartilage, rub against each other. This rubbing damages tissue and bone, and causes pain.

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Author:	Shannon Erstad, MBA/MPH Carrie Henley	Last Updated: July 23, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas S. Renshaw, MD - Orthopedics Andrew Swan, MD, CCFP, FCFP - Family Medicine
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