Hip dislocation and spina bifida
BNO for a week.
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No bowel dilatation or fecal loading. No evidence of perforation.
Tubing in the LUQ is a VP shunt. The posterior elements of several lumbar vertebrae are absent. Mild dextroscoliosis.
The right hip is superiorly dislocated and the left hip is subluxed. Bilateral acetabular dysplasia. Heterotypic ossification between the right pubic rami and proximal femur.
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.