This patient has spina bifida and a VP shunt inserted for hydrocephalus and Arnold Chiari malformation several years ago.

Hip dysplasia and dislocation is more common in patients with spina bifida but the pathophysiology is unclear. It is hypothesized it is multifactorial, due to a combination of abnormal sensation and proprioception, limited motor function, deranged joint development and muscle and soft tissue contractures ¹.