Q65.1 Congenital dislocation of hip, bilateral

Name of the Condition

• Congenital Dislocation of Hip, Bilateral

Summary

Congenital dislocation of the hip, bilateral, is a condition present at birth where the femoral head is not properly seated in the acetabulum of both hip joints. This results in joint instability and can affect hip development if untreated, potentially leading to long-term functional impairment.

Causes

The exact causes are often multifactorial, involving genetic predisposition and developmental factors during pregnancy. Intrauterine positioning, such as breech presentation, may contribute to hip deformities. Genetic factors and familial patterns are also implicated.

Risk Factors

• Female gender
• Breech birth position
• Family history of hip deformities
• Firstborn status
• Oligohydramnios (reduced amniotic fluid)

Symptoms

• Asymmetry in skin folds around the thigh or buttocks
• Limited range of motion in the hip
• Leg length discrepancy
• Clicking or popping sounds during hip movement
• Limp or abnormal gait in older infants

Diagnosis

Physical examination, including tests for hip stability and range of motion, is the initial step. Imaging studies like ultrasound (for infants) or X-rays (for older children) confirm structural abnormalities. Early screening is critical for timely intervention.

Treatment Options

• Pavlik harness or similar orthotic devices for infants to stabilize the hip
• Closed or open surgical procedures

Prognosis and Follow-Up

Early diagnosis and treatment improve outcomes. Regular follow-up is needed to monitor hip development and address any residual issues.

Complications

• Untreated cases may lead to chronic hip instability
• Increased risk of osteoarthritis in adulthood
• Persistent gait abnormalities

Lifestyle & Prevention

• Routine newborn hip screening to detect issues early
• Avoiding restrictive swaddling that limits hip movement
• Following pediatrician guidance for positioning and care

When to Seek Professional Help

Seek medical evaluation if asymmetry in skin folds, limited hip movement, or a limp is observed. Early intervention is key to preventing long-term complications.

Tips for Medical Coders

Document the bilateral nature of the dislocation clearly in the medical record. Ensure the diagnosis is supported by clinical findings and imaging, as bilateral cases require specific coding to reflect both hip involvement.