As early as kindergarten, Anne Atcheson remembers feeling different. It's not that she couldn't skate or do gymnastics. It's that these activities were marred by pain, an experience to which her peers could not relate. The root of Anne's pain was hip dysplasia.
Occurring when the ball and socket joints of the hip fail to form properly, hip dysplasia develops in infants starting in the uterus. When left untreated, it can lead to osteoarthritis and a lifetime of pain, surgery and disability. When caught through early screening, however, it can be cured with a hip brace. One or two in every 100 children are diagnosed with hip dysplasia.
"I felt out of place, weird," Anne says as she recalls certain childhood activities. It's a feeling that returned when she tried to sit cross-legged around the campfire with her fellow Girl Guides, but couldn't do so comfortably.
"I would love it if little girls and boys didn't have to go through this," she says.
From birth to brisk assessment
Dr. Jacob Jaremko, a pediatric musculoskeletal radiologist at the University of Alberta, shares Anne's wish. With Arthritis Society Canada's support, he and his team are creating easy-to-use portable ultrasound devices to detect hip dysplasia in infants.
The technology, driven by artificial intelligence (AI), captures images of babies' hips and compares them to thousands of previously-recorded scans to determine — within seconds — whether there is an abnormality. The devices are currently being piloted in rural Alberta and can be operated by trained professionals, including nurses, physiotherapists and midwives. If a rapid diagnosis is made, a simple, non-invasive hip brace is prescribed to be worn for six weeks.
"The current screening technique for hip dysplasia uses 2D imaging. Unfortunately, because we don't screen everyone, it misses up to 90% of cases," says Dr. Jaremko. "Our 3D technology, aided by AI, is the much-needed answer. We're prioritizing Indigenous populations since Indigenous babies are 12x more likely to be born with hip dysplasia, but our plan is to expand nationwide. The goal is to save people pain and a reduced quality of life, and to save our healthcare system hundreds of millions of dollars."
Dr. Jaremko notes that with the new technology, hip dysplasia can be detected in infants by a nurse using a handheld portable ultrasound scan for $30 and treated with a $100-harness. Each case cured this way saves costs associated with hip arthritis up to $480,000 per patient, or $12,000 per year, by eliminating childhood surgeries and adult treatments, not to mention the burden and suffering of hip pain.
A four-decade ordeal
When Anne was born, she was diagnosed with hip dysplasia; however, the brace she wore for the first six months of her life failed to correct the problem.
Dr. Jaremko says Anne was unlucky, because a brace cures hip dysplasia in more than 90% of babies who are diagnosed early and receive prompt treatment like she did. He adds that no treatment is perfect, but her story reflects that of children diagnosed late. Children whose hip dysplasia is detected after age three months are likely to need hip surgery.
Anne grew up aware of, and came to accept, her condition. It wasn't until she was pregnant with her first child that she realized the severity and significant impact of hip dysplasia. As her hips supported the weight of a baby, occasional pain turned into daily discomfort. This didn't dissipate following her daughter's birth, and it caused her to walk with a limp, which she painfully disguised in public for years. After a failed osteotomy, Anne's hip worsened, and a left hip replacement was required at age 40.
She remembers her first pain-free moment following the procedure: "I couldn't believe it. It was like all the hurt had been cut out. It was, and continues to be, a game-changer for me."
Toward a pain-free future
Although Anne no longer lives with unremitting pain, she is reminded of hip dysplasia's implications. Orthotics, massages, physiotherapy, chiropractic and chiropodist treatments are all part of recovering from decades of misalignment, but she is optimistic about the future — and excited about Dr. Jaremko's project. Anne says, "I love the portability of the device. Diagnostic care can go anywhere!"
She continues: "I'm thrilled this issue is being brought to the forefront. I was a silent sufferer because I thought my condition was fixed as a baby. I think of kids who want to be athletes, doctors, in the military or have careers where they're on their feet all day — how can they excel while in pain? We need to fix this and give our children a pain-free life full of endless possibilities, no matter what path they choose."
For more about Dr Jaremko’s work, contact Carleen Pauliuk , Vice President, Western Canada at cpauliuk@arthritis.ca or Chelsey McNeil, Senior Manager, Development (Prairies) at cmcneil@arthritis.ca.