What to know about hip dysplasia in children and adults

Hip dysplasia occurs when the two bones that come together in the hip joint — the pelvis and femur bones — are out of alignment. The condition can cause misalignment, movement, and flexibility issues for children and adults.

According to the International Hip Dysplasia Institute (IHDI), healthcare professionals refer to hip dysplasia in infants and children as developmental dysplasia of the hip (DDH). If they diagnose hip dysplasia in adults, they refer to it as acetabular dysplasia.

In people with the condition, their hip joint tends to wear out faster, which can lead to additional complications as time goes on.

What is it?

Hip dysplasia is a condition where the bones of the hip do not align properly.

The hip is a large ball-and-socket joint where the thighbone, or femur, fits snuggly into the socket, or acetabulum, of the pelvis in most people. In hip dysplasia, the socket is too shallow or small to fit the thighbone securely.

The severity of hip instability or looseness varies from person to person. According to the American Academy of Orthopaedic Surgeons (AAOS), there are three degrees of hip dysplasia:

• Subluxatable: This is the mildest form. The thighbone fits in the socket and can move around, but the joint will not dislocate.
• Dislocatable: The femur is inside the socket, but during a physical examination, a doctor can easily dislocate the joint.
• Dislocated: This is the most severe case, where the femur is outside the socket.

Doctors may refer to hip dysplasia using different terms, such as:

• neonatal hip instability
• DDH
• acetabular dysplasia

Symptoms

Symptoms of hip dysplasia will depend on a person’s age. Below, we discuss signs and symptoms to watch for in infants, children, teenagers, and adults.

Infants and children

Some infants who are born with DDH do not present with any symptoms.

A person should contact a healthcare professional if they notice in a baby any of the following:

• The skin folds are uneven on the thigh.
• The length of the legs is different.
• The baby is less flexible or mobile on one side of the body.

Children living with hip dysplasia may show similar signs and symptoms, such as:

• uneven leg length
• unusual gait that can include toe walking, limping, or a waddling gait
• limited flexibility or mobility in one of the hips

Teenagers and young adults

According to the AAOS, hip dysplasia in adults typically stems from the development of DDH. Although healthcare professionals routinely screen for the condition, some cases are mild enough that they are left untreated or remain undetected.

In these cases, symptoms may not appear until a person has reached adolescence.

As a child grows, hip dysplasia is more likely to cause pain. The pain often results from a breakdown in the cartilage and other structures in the hip due to irregular wear and tear.

A person may also find that they limp when they walk.

Pain and limping are two most common signs of hip dysplasia in teenagers and young adults.

When pain occurs, it may:

• start as mild and infrequent and change in intensity and frequency over time
• be worse at the end of the day
• be in the groin but may also appear in the outer hip

A person may also experience a popping or crackling feeling in the hip.

Adults

Adults experience symptoms that resemble those in teenagers and young adults.

Some common symptoms include:

• pain in the groin
• increased pain while standing, walking, or moving
• popping or catching sensation in the hip during movement
• pain on the side of the hip
• pain during sleep time
• walking with a limp, which may be painful

When to contact a doctor

When an infant has a high risk of developing DDH, doctors will likely take more steps to rule out its presence. Caregivers should take the baby to regular wellness visits, where a doctor will check for hip dysplasia.

Older children and adults should let a doctor know if they experience symptoms such as pain in the hips, difficulty walking, or limited mobility.

The doctor can check for the presence of hip dysplasia and recommend treatment as needed.

Outlook

With successful treatment, a person should be able to maintain their mobility and lifestyle.

When surgery is necessary, most people can delay the need for a joint replacement and reduce the pain from the condition.

Summary

Hip dysplasia occurs when the thighbone does not fit properly in the hip socket. The condition can cause a disrupted gait, pain, and other symptoms.

Treatment can involve both surgical and nonsurgical options to help alleviate pain and help a person improve mobility and flexibility.

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