Types of Hip Dysplasia

CONGENITAL HIP DISLOCATION (CHD)
- Malformation of hip joint that can be detected exactly after birth;
- Different features such as different length of legs and their asymmetry, uneven thigh fat folds and degraded mobility on the side which was affected;
- Runs in families, and affects more women than men as what clinical studies showed;
- Also there’s a large chance for a baby to have CHD in cases of breech position births;
- First born children are more likely to have CHD than second and third ones;
- Thorough examinations should be administered on the 2nd day of life of the baby to detect CHD.
4 TYPES OF CHD:
a.) Congenital hip dislocation - hip is already dislocated at birth.
b.) Congenital dislocatable hip - hip is in the correct place at birth, but it can dislocate completely under any kind of stress.
c.) Congenital subluxatable hip - hip can dislocate only partially under stress.
d.) Acetabular dysplasia - a situation where acetabulum (the deep cavity into which the head of the thighbone, or femur, is fitted )is shallow and causes hip instability
TYPES OF TESTS FOR DETECTION OF CHD:
1. Barlow and Orlani Test - the main principle used in both methods is moving infant’s hips in order to determine whether femoral head is able to move in and out of the hip joint. It is also effective in the newborn stage;
2. Ultrasonographic detection - diagnostic method using combinations of x-rays and computer technology. This method is effective at examination of any part of body not only hips;
3. Ultrasound Examination
4. X-ray
Prognosis of CHD if not treated shortly after birth will have the baby grow with a limp or waddling gait. Unless surgery is done a child might have difficulties in walking and experience a lot of pain.

DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH)
- a modern medical term used for hip dysplasia showing that in some cases infants having normally developed hips develop hip dysplasia during the first months of life;
- Usually it happens not later than during the first year of life.
- In order to prevent the development of the disease it’s necessary to hold an examination of a newborn baby. In cases if no signs of the disease were found during the first examination, other examination when an infant is one, two, four, six, nine and 12 months old are also required. If during this examinations limited abduction is detected, it could be a trustworthy sign of DHD.


TYPES OF TESTS FOR DETECTION OF DHD:
1. Arthrography of the hip - Arthrograpy is a procedure involving multiple x rays of a joint using a fluoroscope, or a special piece of x-ray equipment which shows an immediate x-ray image. A contrast medium (in this case, a contrast iodine solution) injected into the joint area helps highlight structures of the joint. However this type of examination is not advised to use in newborn babies.
2. Radiography – The technique of producing a photographic image of an opaque specimen by the penetration of radiation such as gamma rays, x-rays, neutrons, or charged particles. When a beam of radiation is transmitted through any heterogeneous object, it is differentially absorbed, depending upon the varying thickness, density, and chemical composition of this object. It is also a term applied to a nondestructive film technique of testing the gross internal structure of any object, whether it be of the chest of a patient for evidence of tuberculosis, silicosis, heart pathology, or embedded foreign objects; of bones in case of fractures or of arthritis or other bone diseases.
However it is not effective when used in children younger than four months, because it cannot show the full picture yet
3. Ultrasonography - diagnostic imaging in which ultrasound is used to image an internal body structure or a developing fetus. It is effective in small infants, and is able to show different abnormal findings if they are present. It is usually used if physical examination detected some sort of abnormalities and in high-risk newborns.
Factors that influence the development of DHD are the same with CHD. They are family tendency, breech presentations and some orthopedic problems, such as clubfoot deformity and other congenital conditions and diseases. Obvious symptoms are infant’s legs of different length, uneven thigh folds and wider space between legs in comparison with normal children.
Developmental hip dislocation may result in even more complicated problems ending up in the development of osteoarthritis. Health problems caused by DHD are knee pain, back pain, abnormal gait and limping.