Coxa Valga Causes, Symptoms, Diagnosis

Coxa valga Causes

Coxa valga is a hip deformity in which head of the femur is abnormal, and articulates improperly with the pelvic bone.  The femoral head has a “ball” shape which connects to the shaft of the bone by a narrow segment.  If this segment has an abnormal angle, the femoral head will not fit into the hip socket, or acetabulum, properly.  This article will discuss why coxa valga occurs, classic symptoms, and how it is diagnosed.   There are a variety of complications that may arise as a result of this hip deformity.  Patients with coxa valga may experience hip pain that prompts them to seek treatment.  Other patients may have a reduced range of hip motion or difficulty walking because of damage to the hip joint.

This condition may be present at birth.  It is seen in 16 out of 1000 newborn infants.  It may also occur in patients who have  neurological or skeletal abnormalities.  For example, children with cerebral palsy may develop coxa valga due to weakened  muscles or contractures that place the hip bones in an incorrect position.  Your doctor will be able to diagnose this disorder via a physical exam and, possibly, imaging studies.

Coxa valga Symptoms

Coxa ValgaCoxa valga can be seen at any age.   In infants, it may be associated with developmental dysplasia of the hip.  Babies typically experience no pain or dysfunction, however, and have lots of cartilaginous tissue in the hip.  Because it can be asymptomatic, it is important for doctors to specifically check for this problem during routine well care visits.  The first sign of coxa valga in children may be a limp detected while walking.  Taking a closer look, one of the child’s legs may appear longer than the other.   By adulthood, a wider angle of the hip forms that can cause a great deal of pain, or a loss of mobility.

As a result of this deformity, patients may lose blood supply and tissue within the hip joint, called avascular necrosis.  This results in a shortening of the affected leg.  Eventually, patients develop difficulty bearing weight or standing on this leg.  This causes a limp and strain on the surrounding muscles.

Coxa valga Diagnosis

For adults who develop hip pain, it is important to see a doctor for a thorough examination.  Your physician will be able to rule out other causes of your pain and mobility issues.  A full physical exam will be necessary to assess your level of function, and your pain.  Your doctor will manipulate your hip in many positions, and make sure that both of your legs are of equal  length.  Hip problems in infants are detected with a specific physical exam procedure, the Barlow and Ortolani tests.  This is a technique of moving the legs to be sure the femur fits properly inside of the hip socket.   For children, limping or dragging the affected leg may be noted.  While standing, one hip may appear higher than the other if a leg length discrepancy is present.

X-ray imaging will also be necessary to observe the femoral head angle, and take appropriate measurements.  An angle greater than 120 degrees in children or 140 degrees in adults is considered diagnostic of coxa valga.  Ultrasound is used under the age of four months due to limited ossification of infant bones.  Once the correct diagnosis has been confirmed, your doctor will determine the best treatment to manage any pain or mobility issues that you may be experiencing.

Cox valga Treatment

For adults who have no symptoms, coxa valga may not need treatment.  It may even go undetected for years until symptoms develop.  If you experience mobility issues or pain, however, it is important to seek treatment early to prevent longterm complications.  Any early signs seen in infants or children should be evaluated as soon as possible to prevent the need for surgery.

If treatment is needed, your doctor may recommend surgical or non surgical treatments.  Non surgical options include physical therapy, or devices that can help to improve mobility such as walkers, canes, or crutches.   If there is muscle spasticity or joint contractures due to a neurological condition, oral antispasmodics or Botox injections may be helpful.

If, however,  surgery is required, your doctor will cut into the narrow segment of the femur, and move it to the correct angle.  This should improve hip mobility, and reduce pain.  As with any surgery, however, there will be pain post-operatively, and complications are possible.  Surgery is not typically the first line of treatment for coxa valga, and is only considered when other options have been exhausted.  

If you’ve been suffering from hip pain, it may be time to see your doctor to evaluate and manage this pain, and regain your mobility.

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