Congenital Hip Dysplasia

Congenital Hip Dysplasia

Congenital hip dysplasia is a hip joint deformity that exists at birth. The femoral head is not secure in the acetabulum and the ligaments at the hip joint may be detached or stretched. This malformation may well be hereditary but some children will present little or no traits and must be determined by a physical examination of the hip joint. Visible signs in children include walking with a limp, walking on toes and waddling stride. Characteristics consist of uneven leg positions, inconsistent fat folds, hip dislocation and decreased movement on the affected hip.

There are a few methods to diagnose congenital hip dysplasia. X-ray films help discern abnormalities of the hip joint allowing correct positioning of the hip joint if a cast is needed. Ultrasound is even more helpful because it permits multiple positioning of the hip joint. The Barlow method is where the doctor places the infant's hips together with the knees totally bent then the doctor places their middle finger over the outside of the hipbone as the thumb is positioned on the medial side of the knee. The hip is pulled away from the body where the doctor can feel whether the hip is sliding in and out of the joint. The Ortolani test is where the doctors hands surround the infants knees, with the second and third fingers turn down toward the infants thigh. Moving the legs apart, the doctor will be able to notice a pronounced clicking noise with the movement.

Exercise programs can be used to strengthen hips and help with hip motion and relieve pain along with medication as nonsurgical treatments. Treatment is needed to return the head of the femur into the hip socket. Some infants are placed in a stiff shell cast to keep the hip in position and in older children surgery may be performed to reposition the hip and then a cast is applied to keep the hip in place. Later on in life, a total hip replacement surgery may be necessary.

Hiatal Hernia

Hiatal Hernia

A hiatal hernia transpires when a portion of the stomach pushes upward through the diaphragm. The diaphragm has a small orifice (hiatus) that permits the esophagus to move through to join the stomach. The stomach can force up through the orifice and create a hiatal hernia.
Most of the time a little hiatal hernia will not even be noticed until you go to see a doctor and he discovers it while you are being checked for something else. Taking care of yourself or taking medication such as acid reducing medicine can typically reduce symptoms. A huge hiatal hernia can cause acid and food to back flow into the esophagus, bringing on belching, heartburn, nausea and chest pain. A large hiatal hernia occasionally requires surgery to pull the stomach down into the abdomen and making the orifice in the diaphragm smaller, rebuilding a weak esophageal sphincter, or eliminating the hernia sac .

A hiatal hernia could be caused by being born with an atypically large hiatus, a genetic weakness in the nearby muscles, injury to the region, and the continuous and acute pressure on the encompassing muscles from vomiting, coughing, or during lifting hefty objects. Hiatal hernia is more typical in people who smoke, who are obese or who are age 50 or older.