Hip Dysplasia in Adults: What Is It and How Do You Know You Have It?
Hip dysplasia means the hip socket is too shallow. It does not cover the ball at the top of the thigh bone properly. In adults, this puts extra stress on the joint. This leads to groin pain, stiffness and early wear. Many people are not diagnosed until their twenties or later. This is because symptoms build slowly, and standard scans taken lying down can underestimate the problem.
Key points
- Hip dysplasia is a structural problem. The hip socket does not fully cover the ball of the femur.
- It is a leading cause of hip arthritis in younger adults, and it is often missed for years.
- Symptoms include groin pain, a feeling that the hip is unstable, and stiffness after sitting.
- Standing, weight-bearing scans show how the joint behaves under load. Scans taken lying down can miss this.
- An early diagnosis helps you and your clinician plan the right next steps before more joint damage happens.
Hip dysplasia is not only found in babies. Many adults live with a shallow hip socket for decades without knowing it. The joint may cope well in your teens and twenties. Over time, though, the uneven load wears down cartilage faster than normal. By the time pain becomes constant, a lot of wear may already be there.
Knowing what hip dysplasia really looks like, and how it should be checked, puts you in a stronger position to get the right help.
What are the signs of hip dysplasia in adults?
The most common sign is a deep ache in the groin or the front of the hip. It is often worse after walking, standing for a long time, or exercise. Many people also notice a catching or clicking feeling in the joint.
A deep ache that gets worse with activity and eases with rest. It is often mistaken for a pulled muscle.
Your hip feels tight or locked when you get up from a chair, especially after sitting for a long time.
A mechanical click or snapping feeling when you move, often when you turn or twist the leg.
A sense that the hip might give way, especially on uneven ground or when you change direction quickly.
Some people also get pain in the side of the hip, lower back or knee. This happens because the body makes up for the unstable joint. Pain in one place can have its real cause somewhere else in the chain.
What causes hip dysplasia in adults?
In most cases, hip dysplasia in adults is a developmental condition that has been there since birth but was never picked up. The socket did not form deep enough in infancy. Other factors that can play a part include genetics, loose ligaments and, less often, injury or repeated loading during growth.
Because the socket is shallow, the ball of the thigh bone is not held as firmly. This uneven contact puts force on a smaller area of cartilage, which speeds up wear. Hip dysplasia is one of the most common structural causes of hip arthritis in people under fifty.
It affects women more often than men, and it sometimes runs in families. If a close relative needed a hip replacement at a fairly young age, it may be worth checking for dysplasia.
How is hip dysplasia diagnosed?
Diagnosis starts with a physical examination. Your clinician will check how far your hip moves, test for signs of impingement and ask about the pattern of your pain. Imaging is then used to confirm the shape of the socket and how well it covers the femoral head.
Standard X-rays taken lying down are useful, but they have an important limit. When you lie flat, gravity is taken away. The muscles around the hip relax, and the joint may look better aligned than it really is. On a lying-down image, the socket may seem to cover the joint well enough, even when the joint is under-covered during everyday standing and walking.
This is where weight-bearing imaging adds real value. A standing X-ray shows the hip under the same load it carries through your day. This gives a more accurate picture of coverage and joint spacing.
When is MRI more useful? EOS shows bones, joints and alignment clearly. For soft-tissue problems such as labral tears, cartilage damage or nerve problems, MRI is usually the better tool. Many people with hip dysplasia benefit from both types of imaging.
Why does a standing EOS scan matter for hip dysplasia?
A standing EOS scan captures your whole skeleton, from head to feet, in one image while you are upright and bearing weight. This matters for hip dysplasia because the shallow socket is under the most stress when you are standing, not when you are lying on a table.
The EOS system also uses about 90% less radiation than a standard X-ray, around ten times less. That makes it a practical option if repeat scans are needed to follow changes over time.
Because the scan captures your full skeleton, your clinician can see whether a shallow hip is also affecting the angle of your pelvis, the curve of your spine or the balance of your leg lengths. Your body is a connected chain. A problem at the hip often forces the spine or knee to make up for it, and pain may show up in those areas instead. A whole-body standing image shows the full picture in one scan.
Want to know how your hip alignment looks under weight? A standing EOS scan can give you and your clinician the full picture.
Book a free video consultationWhat are the next steps after a hip dysplasia diagnosis?
The right approach depends on how severe the dysplasia is, how much cartilage wear is already there, and your symptoms. Your treating clinician will use your scans together with their examination findings to advise you. Common options include:
- Physiotherapy and strengthening. Targeted exercises to improve hip stability and reduce the load on the damaged cartilage.
- Changing activities. Adjusting sports or daily habits to protect the joint while staying fit.
- Surgical assessment. For more significant dysplasia, procedures such as a periacetabular osteotomy (PAO), which repositions the socket, may be discussed. In later stages, where arthritis is advanced, hip replacement may be considered.
ScanAlign is a diagnostic imaging clinic. We do not provide treatment. What we do provide is detailed, weight-bearing imaging that helps your surgeon or physiotherapist plan the most suitable course of action. Accurate imaging early on can make a real difference to the options open to you.
Before you start treatment, or change the treatment you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
Frequently asked questions about hip dysplasia
Most hip dysplasia in adults has been there since birth but was not picked up during childhood screening. It is rare for the shape of the socket to change in adulthood, though symptoms often only appear once the cartilage starts to wear.
Most people describe a deep ache at the front of the hip or in the groin. It tends to get worse with long periods of walking, standing or exercise, and eases with rest. Some people also feel a catching sensation when they move.
No. Dysplasia is the structural shape of the socket. Arthritis is the cartilage wear that can develop over time because of that shape. Dysplasia is a cause, and arthritis is a possible result.
Yes. When the hip is unstable, other joints make up for it. The pelvis may tilt, the spine may curve differently, or the knee may take extra load. Pain can appear in these areas even though the root cause is at the hip.
No referral is needed. ScanAlign is a private, self-pay service. You can book a free video consultation directly to discuss whether a scan is right for you.
The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. This makes it a practical choice for imaging that may need to be repeated over time.
When you lie down, gravity is taken away and the muscles relax. The hip joint may look better covered than it really is in daily life. A standing scan shows the socket under the same load it carries when you walk, stand and move.
The price for patients travelling from abroad is confirmed during the free video consultation. You can also read our FAQs page.
In milder cases, physiotherapy, strengthening and changing activities can manage symptoms effectively. Your treating clinician will advise you based on how severe the dysplasia is and any cartilage changes seen on imaging.
You stand inside the EOS scanner at our clinic at 19 Harley Street, London. The scan takes about 20 seconds and captures your full skeleton in one image. A specialist radiographer oversees the process. Your results and report are shared with you and, if you wish, with your treating clinician. More details are on our what to expect page.
See your hip alignment under real everyday load
A free video consultation lets you talk through your symptoms with our team and find out whether a standing EOS scan is the right next step for you, before you plan a trip to London.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS, "Hip dysplasia," nhs.uk, 2023.
- International Hip Dysplasia Institute, "Adult hip dysplasia overview," hipdysplasia.org.
- Clohisy JC, et al., "A systematic approach to the plain radiographic evaluation of the young adult hip," The Journal of Bone & Joint Surgery, 2008;90(Suppl 4):47-66.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.