Hip dysplasia in a puppy: Does it looks like a spine problem?

What is hip dysplasia?

First of all, YES, you’re right! Hip dysplasia is NOT a neurological problem. Hip dysplasia is the commonest orthopedic condition in dogs and most frequently affects large rapidly growing dogs. It’s a condition primarily genetic  although environmental factors such as obesity during puppyhood may influence whether an animal with predisposed genes will develop a clinical signs . The onset of these most commonly present between 6 and 12 months of age.

What was the clinical history of this case?

This puppy was presented for several weeks of progressive pain and difficulties walking with the hind limbs. He was better with  NSAIDs but the difficulties walking progressed.

What was the clinical examination?

You can observe on this video how the dog can walk, but the hips are so narrow that it’s like bumping into his own hind limbs and it almost looks like being ataxic, BUT HE’S NOT.

With a spinal problems you will have a wide base stance, here in opposite you have a narrowed stance. When performing a clinical examination you would notice the complete reduction of hip extension on this dog and the severe pain on the little hip extension you can do.

What about the neurological examination?

Continuing with our examination we will then perform a neurological exam to asses if the nervous system is affected or not. As this is an orthopedic disease, the neuro exam SHOULD be NORMAL.

Because this dog is painful, he might be weak. Therefore you need to hold his weight properly to perform the proprioception. As you can see on this video the proprioception is normal. But Yes! This is tricky as dogs with severe orthopedic diseases can be painful and interpreting the weakness needs a lot of experience.

The trick on this case will be the narrow walking and your super abnormal ortho exam.

The radiological findings of hip dysplasia include

 Femoral head subluxation or luxation. Present when approximately 50% or more of the femoral head is not within the acetabulum or if the Norberg angle measurement is abnormal.

 Remodelling of the femoral head and neck: loss of spherical shape of the head

 Remodelling of the acetabulum: shallow “C” or cup-shaped acetabulum, remodeling of craniodorsal margin.

 Shift in position of the femoral head in young dogs.

 Irregularity of the cranial acetabular margin to flattened or double-curved line.

 Periarticular osteophytes on the margins of the femoral head and acetabulum.

 Osteophyte formation on the caudal aspect of the femoral neck, known as a caudolateral curvilinear osteophyte (CCO) or Morgan’s line.

 Osteophyte formation on the margin of the femoral head parallel to the physeal scar, which is known as femoral head rimming.

 Subchondral sclerosis of the acetabular margin