Possible Hip Dysplasia in 20 month old.

[Jenkeywoo]

My dd is 20 months and has mild Hemiplegia - cerebral palsy affecting the right side of her body. At the moment she is just starting to get into the crawling position although is a far way off actually crawling. When we had our review with the paediatrician about 6 weeks ago she noticed that DD has trunk instability that it not related to her CP. She also had clicky hips when I'm changing her nappy and the paed measured her as having one leg shorter than the other. The paediatrician suspected Hip dysplasia and ordered an x-ray. The paediatrician looked at the x-ray and declared it normal but was waiting for the Radiologist report. I had a letter today totally out of the blue stating that the Radiologist's report "does not show any major problem but does suggest the hips are at risk of gradually slipping away from the joint". She is referring to us to the orthopaedic surgeon to see what needs to be done.

She hasn't mentioned hip dypsplasia in the letter but do you think that is what she is referring to? Also having googled hip dysplasia I'm now freaking out as it would appear that all treatment at this age involves surgery and being in a cast for weeks on end. I'm presuming the problem is mild as it was missed in the first place, so can you have hip dysplasia and not need any treatment? I'm just so worried now and feel like this little sentence in a letter has left me with something I don't understand and don't know how to deal with.

I've not a lot of time now but will be back later today. I had severe hip dysplasia as a very young child and it did involve casts, splints and surgery (sorry), but your dd's case is realistically not going to be that severe, although at the age she is she is likely to need treatment. On the good side, I am completely functioning now - my only long-term problems are mild and stem from poor aftercare. I don't know how the CP will affect/interact with it, though. More later.

Oh, and btw all hip dysplasias need some form of treatment, though in the very youngest of babies and the mildest of cases it's sometimes enough to put them in double nappies (so their legs are held in a wide position, like in a sling) for a few weeks.

No personal experience but my DS2 has clubbed feet and the charity that has advised me alot is called STEPS they assist in all lower limb abnormalities including hip dysplasia. Check out their hip forum at www.steps-charity.org.uk there is also lots of info on treatment options.

Good luck

Jenkeywoo - my dd had a leg length discrepancy (now resolved by surgery). She had issues with her hips caused by the LLD rather than the other way around IYSWIM. Although I just noted that your dd isn't yet walking so it's probably not relevant as this only became apparent once dd was up on her feet. So ignore....

The STEPS website link posted by babalon is very informative though and well worth a look

Right, I'm back.

I think what you describe is probably dysplasia. I reckon it was extremely mild to start with and has worsened a little as it went missed/untreated. I don't think it's that common to have it on both sides, which is what the letter implies - mine is the right hip and for whatever reason it's much more common in the left. A leg length discrepancy might not be resolved by treatment - I still have one, of about 2cm - but walking (sorry if I am ignorant here, I assume your dd will walk eventually) is not a problem, they can do a lot with shoes, adding extra heel/sole raises that blend in aesthetically with the rest of the shoe. I don't know a lot about my actual treatment, but I know it involved more than one operation (I have fetching scars to prove it) and quite a time in a splint. But I was a very severe case - the hip had actually dislocated. And that was 30 years ago - assume things ahve moved on since. Hope at least some of this helps.

Thank you so much for your replies. I just feel like I'm just starting to get my head around DD's CP (she was only diagnosed 6 months ago) and now have this totally unrelated hip condition to deal with. I've also recently found out that my other DD hs hearing problems and has also been referred for speech therapy. It just seems like we're always having hospital and doctor appointments at the moments! Although I really shouldn't complain as essentially they are both happy, healthy little girlies who thankfully have no idea about these health concerns. I'm going to go on the Steps forum, thank you for the link. Everything I've seen on the site involves surgery and casts at this age - does anyone know if it is treatable any other way if is mild? I feel physically sick at the idea of dd going through all of that. She already has to have physio and varying other tests and procedures so is very wary of anything medical. I just wish all of the poking and prodding could stop but it looks as if we are in for more.

There are various relatively mild brace-type arrangements available for babies, which seeing as your dd is effectively non-mobile (am I right there?) might be considered. Possibly the mentions of casts at this age comes from the fact that children of this age without SN are generally mobile and so need to be effectively 'immobilised'.

Thank you Berolina - I hadn't really considered that as she isn't mobile it is a bit of different case. Yes, her cp is mild enough to mean that she will walk in time, but the reason the hip thing was picked up is that she is more delayed than her CP alone would insinuate. I think it's a shame as her hip problem has almost certainly hidden by her CP which as you say means we're further down the line now than we should be.

my dd had problems with her hips, neither of her hip sockets had fused with the joints -very severe, however, all she needed was a harness for 3 months and she is now fine.

Hi loopylou - how old was your daughter when she had her treatment? I'm glad to hear everything is ok now.