The Hip Click Exam of a Newborn Baby

Newborn babies are examined to ensure there are no conditions that require treatment at a young age. There are a number of conditions found in newborns that can indicate problems with the musculoskeletal system. If these problems are diagnosed early and treated promptly, long-term issues can often be avoided. Hip conditions are one area of particular concern.

Hip joint development is not complete at the time of childbirth, yet if the joint is not properly aligned, there is a high likelihood of the joint not developing properly. When the joint doesn't properly develop, the ball and socket of the hip are not shaped normally.

A newborn at the maternity ward
Catherine Delahaye / Taxi / Getty

Hip Examination

A "hip click" can be a finding on examination of a newborn baby. When babies are born, they are examined to determine if their hips have formed normally. A hip click can be felt by the examiner when the hip joints may not have formed normally.

Two tests are performed, called the Barlow and Ortolani tests, to examine the function of the hip joints. In babies with hip dysplasia, the joint has not formed normally, and the hips are prone to moving in and out of joint. As the hips are moved in these tests, a hip click can be felt by the examiner.

A hip click on examination does not mean the baby has hip dysplasia, but it is a cause for concern. When there is a concern for hip dysplasia, you will likely be referred to a pediatric orthopedist for evaluation. Special tests, such as an ultrasound, can help determine if there is a need for any further evaluation or treatment.

Hip Dysplasia and Newborns

Hip dysplasia is a concern because the ball and socket joints of a newborn's hips are not fully formed. In order to develop properly, the ball must rest securely inside the hip socket. If the hip ball is not firmly seated in the socket, the joint will develop abnormally. Depending on the degree of dysplasia, this may result in an abnormally shallow socket or possible no socket at all.

When the hip joint forms abnormally, the result can be the development of early arthritis. Again, depending on the severity of the problem, this may mean problems in late childhood, or it may mean developing problems as a young or middle-aged adult. When hip dysplasia occurs, the hip joints tend to wear out more quickly, causing early onset of hip arthritis, which may require hip replacement surgery. Performing a hip replacement surgery in a younger individual can affect outcomes, since these implants do not last as long when compared to those employed in older, less active people.

Treatment of hip dysplasia is best accomplished by recognizing the condition as early as possible so that treatment can be initiated. The earlier the condition is identified, the earlier in development the hip can be treated, and therefore your child can have the best possible chance of restored normal hip development. When identified in the first few months of life, often a simple harness can be used to hold the baby's legs in the proper position to restore normal hip development.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. International Hip Dysplasia Institute. Hip Click.

  2. International Hip Dysplasia Institute. Infant Examination.

  3. American Academy of Orthopedic Surgeons. Developmental Dislocation of the Hip.

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.