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Hip dysplasia in teenagers and young adults

Displàsia de maluc en l'adolescent i l'adult jove a Vall d'Hebron

Acetabular, or hip, dysplasia in teenagers and young adults is a malformation of the hip. It is characterised by loss of the concavity of the socket (shallow and flat) and the acetabular ceiling becoming vertical, being badly positioned and covering the head of the femur in a way that creates instability in the hip.

Description

Symptoms

The onset of pain is usually gradual, but it can sometimes be sudden if there is an increase in physical or sporting activity, weight gain or pregnancy.

 

Who is affected by acetabular hip dysplasia?

Despite routine clinical examination and ultrasound on new-borns for detection and early treatment of developmental hip dysplasia, this disorder is still the most common cause of acetabular dysplasia in teenagers and young adults, and the reason behind over 50% of degenerative hip osteoarthritis requiring surgery to fit a full or partial prosthesis, or other techniques to preserve the hip.

Most cases are caused by developmental hip dysplasia, but in others, abnormal development  and growth of the acetabulum is due to a deformity on the head of the femur. Excessive pressure on the joint means the cartilage deteriorates more quickly than normal.

The incidence rate in adults is very variable.  The incidence of developmental hip dysplasia is 1 or 2% in new-borns and 60% of hip osteoarthritis originates in acetabular dysplasia.    

 

Diagnosis

Physical examination may be normal or cause pain in the groin when the hip is flexed with internal rotation and hip adduction. This “impingement test” shows an interjoint anomaly.

An AP standing x-ray and false profile and axial view of the hip are useful to diagnose and assess the severity of the condition. The high-resolution MRI in our centre allows us to see the structures and quality of the cartilage in the joint. If there is still any doubt, an arthroscopy can be performed.

 

Prevention

Early diagnosis of developmental hip dysplasia through routine physical examination (Barlow and Ortolani tests) during the prenatal period and an ultrasound of the hip enable early treatment and prevention of residual acetabular dysplasia.

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