Kanmin-Kogaku Column ㉑: Nurturing hips that will carry you through life, starting from infancy
Walking is an easy way to stay healthy, but few people consciously focus on their hips while walking. As we age, we may experience “pain in the lower back or groin” or “difficulty walking,” sometimes leading to a diagnosis of osteoarthritis of the hip. The estimated number of patients in Japan reaches approximately 12 million, contributing to rising healthcare costs. What is less well known is that one contributing factor can be hip problems originating in infancy.
The hip joint is structured with the rounded head of the thigh bone fitting into the socket of the pelvis. If this joint becomes dislocated or subluxated, or if the socket is shallow (acetabular dysplasia), it can have future consequences. Risk factors include being female, having a family history of hip disease, or breech birth. While these factors cannot be changed, keeping a baby's legs in an “M-shaped” position and providing an environment where they can move freely is effective for preventing dislocation and promoting normal bone development (Figure). Through “preventive care” that can be incorporated into daily activities like holding, diaper changes, and clothing choices, you can nurture hips that will support walking for a lifetime. Prevention is better than cure. To achieve health equity, we are developing educational materials so that anyone can practice preventive care for infant hip dislocation anytime, anywhere.
Early detection is also crucial. Early identification allows for simple treatment, reducing the burden on the baby and family while also preventing future osteoarthritis of the hip. While manual hip abduction checks have been used, ultrasound is optimal for reliable observation. Therefore, with the cooperation of public health nurses, physicians, engineering researchers, and parents in Okinawa and Aichi Prefectures, we have initiated research utilizing existing municipal maternal and child health services (newborn home visits and childcare consultations) – known for their high equity – to perform ultrasound examinations. Physicians then review the images to enable early detection of issues and prompt medical consultation. Public health nurses also provide preventive care guidance to all parents whose infants undergo screening, receiving immense gratitude from them.
We aim to accelerate this research, disseminate the technique to nursing professionals nationwide, and ensure all infants can receive preventive care and ultrasound screening locally. We are also advancing research on adult degenerative hip joint disease, where detection has often been delayed. Together with CHANGE and citizens, we strive to promote “building hips that can walk for life” and realize a society where people can live healthy and happy lives.
