Hip Dysplasia

Hip dysplasia occurs when the acetabulum fails to fully cover the femoral head, leading to a shallow hip socket. Most individuals with hip dysplasia are born with the condition. Approximately 1 in 10,000 babies are born with hip dysplasia and females and first-born children are more likely to have it. Hip dysplasia can be caused while in the womb by increased pressure on the hips during development. First pregnancy, large baby, and breech position (abnormal baby position in the womb) are all risk factors that reduce the amount of space and increase the pressure within the womb. Hip dysplasia may also be genetic, meaning passed down in families.

Symptoms of hip dysplasia may present at different stages of life. In infancy, hip dysplasia may present with unequal leg lengths. The affected hip may also be less flexible than the other during diaper changes. Once the child learns to walk, they may develop a limp on the affected hip. In young adults, hip dysplasia may cause tears to the labrum or early stages of arthritis. Symptoms that adolescents and young adults may experience are the following:

• Intermittent deep groin pain or ache (most common)
• Pain at the outside of the hip joint
• Sharp stabbing pain when twisting, turning, or squatting, such as when getting in or out of a car or a chair.
• A dull ache from prolonged sitting or walking
• A sensation of catching, clicking, or locking in the hip joint during movement
• Instability of the hip joint
• Stiffness and reduced flexibility in the hip joint
• Limping

During your consultation with Dr. Jorge Chahla, a Chicago sports medicine surgeon and hip dysplasia specialist, your medical history, hip dysplasia symptoms, and past injuries will be reviewed.

Physical Exam

He will conduct a physical examination checking range of motion including flexion, adduction, and rotation to diagnose your hip impingement. The hip impingement test will also be performed during your physical exam. This is a test in which Dr. Chahla will ask you to bring your knee to your chest while Dr. Chahla rotates the knee in toward the opposite shoulder (FADIR [flexion, adduction, and internal rotation]). If the hip impingement test causes pain, you likely have a hip labral tear.  There may be sensation of instability or micro motion inside the hip joint that can lead to overload the cartilage, muscles, and tendons around the joint. A comprehensive physical exam is key to determine the cause of your hip pain, as it can indicate if the ball fits properly within the socket.

Imaging

Diagnostic imaging is necessary to definitively diagnose hip dysplasia and a possible associated labral tear.  X-rays will reveal less coverage of the hip ball (socket can be very shallow), and an MRI will reveal damage to the soft tissue, such as the labrum (a hip labral tear) and or the cartilage as it can be affected from instability or overload. A CT scan is typically ordered to learn details about the shape of the bones, location of any abnormal bone growth, and the rotation of the bones.

Hip Injection

An intra-articular hip injection can help to confirm the diagnosis of symptoms associated with hip dysplasia. This injection will be performed in the office at the time of your office visit under ultrasound guidance. If the majority of your pain goes away, even temporarily, following the injection, then it confirms that the source of the pain is due to intra-articular hip pathology.