We recently created a new algorithm for infant hip dysplasia to walk providers through the process of evaluating, diagnosing and referring their patients from birth to 2 years old. Q: How are you helping PCPs know when to refer? I probably see about 10 to 15 new hip patients each week. I also see adolescents and young adults with hip dysplasia. While many of these screening studies are normal, I see the infants with abnormal exams and ultrasounds, as well as older children who were previously treated for hip dysplasia and need continued follow-up to confirm that their hips have developed appropriately. Our ultrasonographers perform around 5,000 screening infant hip ultrasounds annually across all the Seattle Children’s clinical sites. We are the highest-volume center for hip dysplasia in the Pacific Northwest. In addition to a screening ultrasound at 6 weeks, a single anterior-posterior (AP) pelvis radiograph at 6 months is also recommended. Q: Do breech babies need additional screening when they are older?īreech presentation is felt to be a particularly strong risk factor for hip dysplasia, even in the setting of a normal physical exam. For babies with any of the risk factors noted above or an inconclusive exam, an ultrasound at 6 weeks of age is the ideal time to screen. The most sensitive test for a hip dislocation is the Ortolani maneuver, an exam maneuver where a palpable “clunk” is appreciated as the hip reduces back into the socket in flexion and abduction. Q: How are babies screened for hip dysplasia?Īll babies are screened with clinical exams at multiple points, assessing for instability in the hips, asymmetric abduction and relative leg-length differences that could indicate that one hip is out of the socket. In general, preterm infants are at lower risk for hip dysplasia, but should still be screened if they meet the criteria at the corrected age. Females have a higher incidence of hip dysplasia than males, but sex is not considered a specific risk factor for screening purposes. Risk factors for hip dysplasia include breach position at any point after 32 weeks gestation, family history of hip dysplasia in parents or siblings and improper swaddling with the hips immobilized in extension and adduction (knees together). Q: How common is hip dysplasia, and what are the risk factors for infant hip dysplasia?Ībout 1 in 100 babies has signs of hip instability at birth, and hip dislocations are identified in approximately 1 in 1000 newborns. Blumberg is an orthopedic surgeon who works with patients from infancy through young adulthood treating all hip conditions.

Normal hip xray male