When a baby with dislocated hips walks, he or she has a waddling gait that is a little more exaggerated than a normal toddler gait. When both hips are dislocated, the exam is symmetrical. The hips could be a little loose, but otherwise fine, and then get progressively worse as the baby gets older, especially if they slip farther out of the socket when the baby is relaxed, such as while sleeping. Hip dysplasia can be difficult to diagnose, especially if it is bilateral (both hips are affected) because the hips are symmetrical. An x-ray at four months of age or older is sometimes recommended. Babies with other risk factors may also benefit from an ultrasound, especially when the pediatrician has any concerns about the examination of the hips. The American Academy of Pediatrics recommends an ultrasound study at six weeks of age for almost all baby girls who were in the breech, or bottom-first position. There are signs and symptoms of a possible hip problem, such as a limp in a child of walking age.The doctor is concerned about the results of the physical exam. There is a family history of hip dysplasia.Babies are at increased risk for hip dysplasia in the following situations:The baby is a twin or multiple, or was in a breech position at birth.Standard practice in the developed world is to do hip exams for newborns and babies for hip dysplasia at well-baby checkups.
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