Host: When babies are born you see a pediatrician checking the hips and he is trying to make them go out and in and around and he worried about something and the term they use is Hip Dysplasia; what's a Hip Dysplasia?
Guest: One thing that us as doctors whether it is a pediatrician or an orthopedist is always interested in looking for in a newborn baby is to check for a Hip Dysplasia as you termed, which is a condition that about one in a 1,000 babies are born with where the hip is unstable and dislocated and the thing that's very important is that if that condition is present in a baby that we identify it as early as possible and for that reason whether it's myself or the pediatrician that's one of the things that we check all newborn babies for.
Host: How is it diagnosed?
Guest: Diagnosis is in almost all cases based on physical examination. So your pediatrician or your orthopedist is trained and experienced in examining the hips.
Host: No what would be the classical signs, sometimes you see a leg that is longer the other one. Is that one of the signs?
Guest: The most common thing that the pediatrician will find in the newborn baby or in the first couple weeks is when they examine the hips they will feel the hip moving in and out of position.
Host: So it is loose -- and say it is a little loose?
Guest: Occasionally, the kids that are a little older, a few months old the pediatrician may notice the difference in the leg lengths or they may notice that one hip has less motion than another.
Host: And if you do make the diagnosis, how is that treated.
Guest: What will happen in most situations is that your pediatrician will refer you to an orthopedist. Orthopedist will confirm the diagnosis either based on exam or occasionally some type of imaging study, either an ultrasound or an X-ray.
Host: And what will do at that particular point?
Guest: So the most common scenario is that we have a newborn infant or infant in the first six weeks of life where the hip instability is identified, send them to us and if in fact the hip is unstable they will be placed in to a brace.
Host: If for some reason it's diagnosed, kind of, late say nine months to the year, can that be fixed at that age?
Guest: Yeah, even in the best start physician’s hands, whether it is the pediatrician or the orthopedist, there will be some children where the diagnosis is very difficult to make. So we do still see some kids that are older, eight nine months over a year with a dislocated hip and those too can be treated, but the treatments are a little different. Some of those kids may need to be in a cast and occasionally some of the kids may need a surgery to give them the best result to their hip. But I would emphasize that many kids we treat with this problem it's only a small percentage that go on to need surgery.
Host: If they do have this condition and you do treat it they end being perfectly okay.
Guest: The majority of kids, a lot of the outcome, will depend on what we have to start out with, but if you take all the children that I treated or most pediatric orthopedist treat, the majority 80% or so, will end up with a normal hip and they should really have no more problems than anyone else.
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