Developmental defects of the musculoskeletal system

Musculoskeletal malformations in children and adolescents develop insidiously, painlessly and often asymptomatically. Left without early diagnosis and treatment, they worsen with growth and uprightness, subsequently leading to early onset of generative and degenerative changes and eventually to permanent disability. This is why it is so important to detect and then treat any musculoskeletal disease as soon as possible.

In newborns and infants, among malformations of the locomotor system, developmental hip dysplasia is primarily diagnosed, while in children and adolescents, static and dynamic forms of postural defects (curvatures of the spine, foot defects, muscle dysfunctions).

What is developmental hip dysplasia?

Infantile hip dysplasia, a developmental disorder in the formation and development of a child's hip, is the most common malformation in newborns. The condition develops as early as during pregnancy. It more often affects girls and the left hip. Its causes are not fully understood, although risk factors include abnormal positioning of the embryo, too much fetal weight or too little amniotic fluid occurring in the 3rd trimester of pregnancy.

Hip dysplasia - symptoms

Hip dysplasia is a malformation of the musculoskeletal system, which has different symptoms depending on the age of the patient and the severity of the defect. In a newborn, the most common symptoms are flaccidity and instability of the joint. Other symptoms indicating the presence of hip dysplasia include:

1. Barlow's positive sign,
2. Ortolani's positive sign,
3. Deepening and reddening of the groin,
4. Limitation of hip inversion movement,
5. Asymmetry of placement of the lower extremities,
6. Arranging the whole body into the letter C,
7. Placing the head in rotation continuously in one direction,
8. Asymmetries of certain folds, especially the so-called femoral, inguinal and gluteal folds.

Hip dysplasia - diagnosis

Hip dysplasia affects people of all ages, but this musculoskeletal malformation can be cured conservatively and completely only in infancy. Therefore, it is important to detect this condition as soon as possible and start appropriate treatment.

The first examination should be performed in the neonatal ward in the first week of the child's life. If abnormalities are detected, conservative treatment should be started immediately and the examination should be performed again in the sixth week of life.

In children whose abnormalities are not detected, a second examination should be performed in the third month of life to assess the development of the joint, make a definitive diagnosis and catch any abnormalities. The above examination should be carried out by an orthopedist.

Currently, early screening orthopedic-ultrasound examination according to the standards developed by Professor R. Graf is considered the optimal diagnostic method for hip joints. In addition to the physical examination, an ultrasound (USG) examination is carried out, which makes it possible to classify the patient's congenital malformation of the musculoskeletal system into one of the four types in Graf's classification.

Graf classification:

Type I - healthy hip joints
Type II - physiologically immature hip joints (IIa and IIb), dysplastic hip joints without decentration of the femoral head in the acetabulum (IIc)
Type III - dysplastic hip joints with decentration of the femoral head in the acetabulum
Type IV - dislocated hip joints

Interpretation of tests in newborns and infants is often very difficult, subjective. In addition, hip dysplasia is very often asymptomatic. All this makes it easy to make a diagnostic mistake. Therefore, it is important that the diagnosis and treatment of this musculoskeletal disorder be carried out by an experienced specialist.

Failure to adequately treat hip dysplasia - consequences

If left untreated, hip dysplasia can lead to the onset of generative and degenerative changes and irreversible damage that permanently limit physical fitness. Dislocation and subluxation of the joint causes gait impairment and noticeable symptoms as early as childhood.

Comprehensive treatment of hip dysplasia at Paley European Institute

At Paley European Institute, experienced specialists provide comprehensive care for people with hip dysplasia, physiological myelopathy and other musculoskeletal malformations of various causes. Pediatric orthopedics also offers help with osteochondrodysplasia or limb axis deformities.