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Family history
Family occurrence of Congenital or Developmental dysplasia of Hips is over 80%. This disorder creates most problems as it comes to diagnostics and treatment. This is why gathering information on family history of hips dysplasia in infants is very important. Most parents don't know the importance of family occurrence. On the first visit only 10% of them know of DDH in their family. You have to ask multiple times with patience.
It may prove difficult to find out whether to not there have been cases of DDH in the family because mass prevention was started in the seventies of the last century.
At the beginning, the main doctor who wants to conduct medical history, should find out if a closely related family (parents, siblings, grandparents, uncles, aunts and their children etc ..) had:
Risk factors for DDH;
(increasing the possibility for hip development disorders):
1. (positive?) family history : we are dealing when the following ailments occur in the family:
(remember how difficult it is to get information from parents, usually people do not know that some abnormalities were found during their hip examination. Commonly, information about hip disorders are considered to be of little relevance at a later time, and especially for the examined child in the future):
- problem with hips after birth; what was the type of hips ultrasound, have they been treated?
- Adults’ hip pain; whether in later life period as an adult, patient can feels reccuring pain of hip joint, also can occur blockade of the Hip the so called crunching or patient may seemed that one of his leg is shorter.
- hip surgery;
- family history of thyroid problems;
2. Breech birth; wrong position of the baby during labor may cause a mechanical damage to individual hip components.
3. Suspicion of neurological disorders, especially the cerebellum (proprioception), can cause muscular tension control disorder, including active stabilizers of hip-joint.
4. Suspicion of increased thyroid hormone (TSH) during the first trimester of pregnancy; especially for females, excessive level triiodothyronine can disrupt the formation of the child hip. - one of the most common symptoms which may suggest that woman have increased triiodothyronine level is excessive vomiting during pregnancy.
In case of any of the these risk factors, it is recommended that the first ultrasound examination of the hip should be carried out in the first days after birth(up to 3 days!!!), preferably during the child's stay in the neonatal unit or just after leaving.
In the period after birth children often suffer for rickets () therefore, the doctor should ask if parents has noticed in a child:
- Crooked legs (valgus, varus)
- Protruding ribs
The doctor completes the patient interview asking about:
- other defects
-allergies
- At what age did children from the close family began: sit down, get up, walk.
This additional difficulty lingering information is important for the doctor because it allows him to compare the child's development with the family pattern.
In the case of other defects or disorders it is better to tell doctor. This will allow f.e.: preventing family rickets by increasing the dose of vitamin D or ultrasound examination of the hip in a neonatal unit.
PS
An today is the victorian philosophy that
birth defect is received from "God" to improve our character.
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