Diagnosing a hip condition


October 11, 1994|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,Special to The Sun

Q: I had to have an operation on my hip when I was 3 years old, because I walked with a limp. My mother says my hip was out of place when I was born. I'm afraid my newborn baby girl will have the same problem. How can I tell?

A: The upper leg bone, the femur, ends in a bail of bone, the femoral head. The femoral head should fit nicely into a socket, the acetabulum, formed by the pelvic bones. Together with the strong tissue around them, these bones form the hip joint. In some babies the femoral head does not line up with the socket properly on one or both sides. This is congenital (meaning from birth) dislocation of the hip, or CHD.

It sounds like you had CHD. CHD may result from pressure on the hip in the womb. There must be other factors which play a part, too; because girls are more likely to have CHD than boys, and it does tend to run in families. CHD occurs in only 1 in 1,000 or 1 in 100 babies. The risk of your baby having CHD since you had it is higher, perhaps as likely as 1 in 25 or 1 in 10.

It can be impossible for a parent to tell that a baby's hips are out of place, but it's important to try to do so before walking age. That's why the doctor examines a baby's legs and hips carefully at each baby visit. Tell your baby's doctor that you had CHD. The doctor may want to order a hip ultrasound examination for your baby. Ultrasound can give an excellent picture of your baby's hips without any discomfort or radiation.

Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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