Diagnosing Hip Dysplasia: Where we are now

Diagnosing Hip Dysplasia: Where we are now

It has been a while since I wrote about DDH, it seems like a long time since it was such a major factor in our world.  Its legacy lives on, but in a positive way.  My smallest child has a scar of bravery running along her left hip, and every time we hit a physical milestone in her life  – I celebrate louder than most.

And considering I do most things louder than most – that is pretty vocal.

This week Libby-Sue has moved on milestones with the bike.

She has been riding on and off for a year or so, but endurance, speed and balance have not been her friend.  My heart has a holiday home in my mouth reserved for whenever she takes her two-wheeled buddy out of the garage, and she has been so desperate to increase her ability.

This week she has managed the momentous task of cycling to school.

She gets on the bike, and I stagger behind with school bag, lunch box, water bottle, house keys and a bucket load of fear.  She hurtles down our street, finally working on speed, and I leg it behind her, pointing out cars, people, dogs and anything that could send her flying.

It is a workout and a half for me.

By the time I get home from school I am ready for my mid morning gin.

She still suffers with residual pain in her knees, which we think is part of the DDH legacy.  We still don’t know if she will need more surgery.  At last X-Ray a blot on her hip was identified.  If it stays the size it is, we are all clear, if it grows – well, I am not letting my thoughts go there yet.  She has already had her fair share of operations and casts.

If you don’t remember: she was diagnosed late – at 18 months.

The World Journal of Orthoepedics states:

Early diagnosis and treatment is critical to provide the best possible functional outcome. Different screening programs have been devised to recognize DDH as soon as possible. Despite efforts to recognize and treat all cases of DDH soon after birth, the diagnosis is delayed in some children. Treatment of DDH changes with the age at presentation. At a later age, treatment involves more extensive surgery with more complications with a worse functional outcome.

The what if she was diagnosed at birth has always haunted me…

Because although my baby girl is better than fine, she still didn’t walk till she was almost three, she still had major surgery multiple times, as a family we had to change jobs, lifestyles, and it was hard.  Really, really hard, any DDH parent will tell you that.

And still, kids are missed at birth.

It would only take an ultrasound or an x-ray to confirm a ‘clicky hip’; or at the very least more information and education to new parents.  Still in my local children’s group and doctors surgery there is nothing to warn parents about the signs of hip dysplasia.

Currently, according to the STEP’S website…

If the physical examination is normal NHS guidelines say that your baby’s hips will have an ultrasound examination within 6 weeks if the following applies:
•    there is a history of early childhood hip problems in your family or
•    your baby was in the breech position: around 36 weeks of pregnancy even if the baby turned for head first delivery.
•    born before 36 weeks in a breech position.
•    in a multiple birth, if any of the babies is in either of the groups above, every baby should have an ultrasound examination.

We have no history of early childhood hip problems, my daughter was head first, and thankfully, she didn’t come as part of a pair and she rocked up at 39.5 weeks.

So we were missed,  leading to a Pemberton Ostemory, and blood transfusion in 2012.  I would love to see a world where every baby was hip screened at six weeks.   I know parents who feel strongly that it is a case of negligence where their child has been missed by the health service because of the lack of knowledge on Hip Dysplasia, and some who are fighting to make their voices heard, using companies like yourlegalfriend.com.

Because education and knowledge can be huge differentiatiors in when cases of DDH are diagnosed.

The Signs

Leg length difference.

Asymmetrical creases on their thighs or bottom (an extra crease or two.)

Dragging a leg when crawling.

Hearing a click when nappy changing.

I met a lady recently who had a daughter who was diagnosed at birth, she was devastated.  We share our experiences, we hugged, and thankfully, she walked away happier knowing that because of the date of diagnosis her daughter would hopefully only have to wear a Palvek Harness for 12 weeks.  Hopefully, not having to face some of the major surgeries that kids diagnosed late automiatically have to cope with.

For now, DDH is a distance memory, but only for us.

Be great to see a change in awareness.

ddh

 

 

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2 Comments

  1. October 6, 2017 / 2:05 pm

    Hi Jane,

    Can I also add that as and when a baby walks they quite often will walk on tiptoes – this is a classic sign that was missed in me. My mum actually wrote in my baby book that “I walked like a drunkard”! I walked aged 11 months which is unusually early considering mine was bi-lateral Hip Dysplasia.

    So good to read Libby-Sue’s improvements.

    Best wishes

    Annick

  2. Melissa
    October 8, 2017 / 10:00 pm

    So glad to hear she is doing well! I was diagnosed around 18 months as well- my father took me to the doctors that refused to believe my mother, stripped me down and walked me down the hallway. My limp was so severe they immediately took me to the hospial, giving my parents a fright.
    I had several different surgeries-this was in 1979/80- the first was to pull the muscles of my inner thigh together and ‘hold’ my hip in place after running a rod through the back part of my knee, eventually they did a bone transplant to give me a socket.
    I’m 37 now. I’ve had my fair share of arthritis, which started in high school. I’ve been overlooked by doctors because I’m ‘too young’ for arthritis, even though it shows on x-rays along with my history of surgeries. At 27, I had knee surgery-that cast I wore while growing made my knees grow sideways, and both my patellas sit on the side. Well, just one, now.
    Your daughter has more obstacles, I’m giving you the ones I know about through experience, but it sounds like you have a good handle on things.

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