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CT, can you tell me more about this? My 16 month old daughter has a limp to her walk. It's always been there, making her look a little like a sailor who's been on board ship too long. I figured that it was just a toddler-learning-to-walk thing, but a close friend of mine (an LPN) was watching her for a few days while hubby and I went out of town, and she was pretty concerned about it after we got back. So I had to take my daughter to the doc's office yesterday for a possible sinus infection, (our regular doc is out of town) and asked about the limp. He watched her for a little bit and said, "yeah, you'll want to have that looked at". I have an appointment with our regular doc in a little over a week. The doc we had yesterday though said that it would most likely be hip dysplasia. When I asked what they do to fix it, if that's what it is, he said surgery.
She's been to all her well baby appts and our doc did the hip manipulation thing each time. Is it possible for it to go undiagnosed this long? And what kind of surgery are we talking about? I'm probably freaking out too soon. But since we know she also has Dwayne's Syndrome (an eye problem that you really don't notice unless she's tired), I'm wondering if having older parents (I'm 35, daddy is 43) really wasn't all that good for her. I'm hoping that being armed with some information will make me feel better.
jeniwren, although hip dysplasia can be missed, it would be odd not to have had it picked up on general physical exams. Part of the physical examination of infants includes a forceful attempt to dislocate the hip joint both anteriorly and posteriorly. In theory, the physician puts much more of a stress on the hips than would be experienced by walking, and then feels for the "clunk" of dislocation. If caught early, the only necessary treatment often is to keep the baby in frog-leg position (straddling your hip, or as "double-diapered") in order to encourage the head of the femur back into the joint.
However, I seem to remember that some slight cases can be missed. I'll do some research for you.
Posts: 14017 | Registered: May 2000
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jeniwren, there's a great article at emedicine in the radiology section.
Note that they discuss "significant morbidity," which means problems (bad enough), but is not the same as "mortality" (death). It sounds like your little'un may well have a long road ahead of her, although finding it now is much better than later in life.
I've never heard of Dwayne's Syndrome before, but I will continue to read up on it. It doesn't seem to be associated with a generalized muscle weakness, although if it were, that could help explain the late finding of dislocation. I'm really not sure.
The forceful attempts to dislocate the hip which I mentioned above apparently become less useful as the child ages. A discrepancy in limb leg seems to be the most sensitive indication of a problem. If she's limping because of a difference in leg lengths, then she might well be a candidate for a closed reduction of the hip (that is, they try to put it back in place without opening up the joint). However, if the problem has been around for awhile, it likely would have affected how the joint developed, so they might have to make some changes via direct open surgery on the joint.
I wish I had a more optomistic take on this. But nobody will know for sure what is going on until a specialist sees here. Still, I've never ever heard of a connection between hip dysplasia (which is relatively common) and advanced age of the parents, so definitely don't beat yourself up over that. I bet it's sheer coincidence, although I will try to confirm that for you, as well.
*fingers crossed, you're in my thoughts
Posts: 14017 | Registered: May 2000
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Thanks ludosti and Pop. Hugs are very well appreciated!
CT, thank you so much! I don't figure that the Dwayne's Syndrome has anything to do with her limp. I don't know anyone in my family who has ever had it, but as I understand it, she's a pretty typical case, female and left eye. It has something to do with the sixth cranial nerve never developing, or something like that. No cure, but like I said, you really don't notice it unless she's tired. Then you can tell that her left eye doesn't go any further left than the midline. Mostly, she just turns her head and you can't tell. The only real concern is that she has a strong probability for lazy eye, so we take her to the opthamologist every three months for checkups.
I'll read that article. Even bad news is better if you know as much as possible about it. And I will continue to hope that it's just a quirk.
There is a more broadspread article about assessment of the limping child, also at emedicine. Again, it uses technical terminology, but you are more than welcome to email/post with any necessary requests for clarification, or if you'd just like a summary.
About being older parents -- jeniwren, my parents were much older than typical when they had me (45 and 65). The benefits of wisdom, life experience, and knowing how to love well that came from those extra years was irreplaceable. I wouldn't have traded them for the world.
Posts: 14017 | Registered: May 2000
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Wow, that's a great article. It could be lots of stuff. Well, that's a relief! Now we just play the waiting game.
Thank you for your reassurance about being older parents...I was so worried about Down Syndrome when I was pregnant, since I always understood it was more prevalent as the age of the parents gets up there. Obviously that wasn't a problem. But when the Dwayne's Syndrome surfaced, I kinda wondered. Still, knowing YOU are from quite a bit older parents than our Rainbow, is cause for great comfort. Posts: 5948 | Registered: Jun 2001
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I have a friend who has two daughters who had hip displaysia. Both had surgery, and both are fine. They are adults, 38 and 35. One does have a little strange walk, but nothing any weirder than anyone else. You only notice it after she tells you about it. She also does a 6 mile power walk every day.
quote: Dwayne's Syndrome (an eye problem that you really don't notice unless she's tired
Is that when both eyes don't line up when she looks to the side? I think that's what my sisterhas, but I don't remember.
Posts: 8473 | Registered: Apr 2003
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Rain, her name is Rayne, pronounced just like yours. That's why I asked that time if you liked your name. I wasn't quite brave enough to spell it just like yours. We call her Rainbow and Raindrop and RainyDay, anything that goes with Rain. Thank you for the words of encouragement. I am sure she'll be fine, it's just hairy thinking about her having to have surgery, which is a bit of future-tripping right now.
Teshi, yeah, that's it. Her right eye has full range of movement, but her left eye can only look up, down and to the right. She can't move it to the left at all. So when she looks to the left with her right eye, the left one looks straight forward. It's really weird looking. Posts: 5948 | Registered: Jun 2001
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:whacks self upside the head: Oh, yeah! You just told me that a few days ago.
And, not only is my friend amazing for walking 6 miles every day, but she is about to have a baby at age 39 while still raising teenagers. Wonder Woman! It's a boy, or she would have named it after me.
Posts: 1379 | Registered: Feb 2002
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Rain, I thought if Rayne had been a boy, we'd name him Rain anyway. But my brother among others (not my husband, though) were insistant that it was not a boy's name. Then I was teaching 1st graders in church a few months ago and had a little boy named Rain in my class. Not that that was a real recommendation...he didn't like his name very much.
It makes a very nice girl's name.
Your friend really IS a superwoman. I can't imagine being pregnant again at 39. It was hard enough at 34.
Posts: 5948 | Registered: Jun 2001
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jeniwren, Abigail had hip dysplasia, I suppose when she was a newborn. They described it as a "hip click" which I assume is the same thing CT referred to, because they said her hip was clicking when they manipulated it.
She was monitored by ultrasound on several occasions until the angle of the joint returned to normal and she has no problems now. (I'm probably butchering my description, CT will correct me I hope!)
Anyway, they told me her condition was more likely in 1) girls 2) breech babies and 3) multiples.
Abigail hit all three risk factors, poor thing!
I'll send some prayers and virtual hugs down the pipeline to you and Rayne. Let us know when you hear something.
((((Rayne and Mommy)))
Posts: 14428 | Registered: Aug 2001
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I took Rayne in to have the limp looked at. For whatever reason, I mixed up my appointment cards and thought it was at 9:30 this morning, but when I got there, discovered it wasn't until 1:40 this afternoon. They had a resident there who was available, so since I didn't object, they placed me with her. She was great, even though she looked like she just graduated from high school. Very professional and thorough.
She watched Rayne walk up and down the hall, which Rayne was more than happy to do. There was a slight limp, where her right knee swung out. Very slight limp. The resident wasn't sure, so she brought one of the regular docs to come watch. They both did the hip manipulation thing, and didn't find anything out of order. No popping, very smooth motion. But the slight limp was a concern, so even though the regular doc was pretty sure it wasn't anything to be concerned about, he went ahead and ordered X-Rays.
Half an hour later, we were back talking about the X-Rays. Turns out that she does have a problem. The left hip socket isn't formed properly, because the ball of the femur isn't the right size or shape. It's not a huge difference, but it's significant enough. The socket is more flat than round, and Rayne has been compensating with her right leg to walk.
They want us to see a pediatric orthopedic surgeon, which means a trip to Seattle to Children's Hospital. As I understand it, this means either casting (less likely because of her age) or surgery.
Not quite what I was expecting, so I'm still catching my breath. She just looks so perfect, it is a little hard to believe.
Posts: 5948 | Registered: Jun 2001
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I got the call from the hospital in Seattle. Our appointment is on the 29th, so if you guys can keep us in mind that day, I'd really appreciate it.
Posts: 5948 | Registered: Jun 2001
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We just got back from Children's Hospital in Seattle, and it's affirmative on the hip dysplasia.
Because of how the hip socket is shaped, it means surgery, where they will have to build the socket from bone taken elsewhere on the hip. It will be a five hour surgery with two days in the hospital. Then she'll be in a cast for 6 weeks, another cast for another 6 weeks, and then a brace for 12 weeks. She should be done right around the time she turns 2.
Uff. It was what we were hoping it wouldn't be, and it could be so much worse... And we got to talk to a mom whose daughter is just now getting out of her second cast, and into her brace. So that helped a lot. But you might say we're a little shell shocked.
As the mom we talked to said, it's harder on the parents than it is on the kids...I anticipate a few days of frustration from Rayne about being unable to walk, then she'll figure out how to get around and everything will be fine in her world again.
So...if you remembered us today, thank you. And if you'd mark your calendar to remember us on October 22nd, that would be great. That's the day of the surgery. Thanks. Posts: 5948 | Registered: Jun 2001
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I'm sorry to hear that Rayne is going to need surgery (and months of casts/braces). At least she will probably be young enough to not remember it when she gets older. Stay strong and be sure to let us know how the surgery goes. (((jeniwren, Rayne)))
Posts: 5879 | Registered: Apr 2001
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Thanks, rivka, Soapy, ludosti. We're trying to figure out logistics and how much all this is going to cost, but I really feel blessed. We know what's wrong and that it's correctible...and it's not remotely life threatening.
Our lamaze class is having a reunion the weekend before the surgery, and I heard from one family in the group this morning that they may not be there because their daughter has been in and out of Children's recently also. They are testing for leukemia now, as her platelets are way too low. So we're praying for them, and hoping to get to see them when we're down there for our pre-op appointment.
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But since we know she also has Dwayne's Syndrome (an eye problem that you really don't notice unless she's tired), I'm wondering if having older parents (I'm 35, daddy is 43) really wasn't all that good for her. I'm hoping that being armed with some information will make me feel better.
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