What causes hip pain in children?
There are many causes of hip pain in children.
Hip pain in children can occur due to various reasons. Causes may include the following:
- Congenital (any deformity present since birth)
- Faulty posture
- Infections
- Inflammatory diseases
- Trauma (fracture and accidents)
- Irritated nerves
- Tumors (cancerous or non-cancerous/benign)
A hip problem can be hard to deal with, both for the child who has the problem and for their parents or caregivers. A child who has a hip problem may feel pain in their hip, groin, thigh, or knee. A child in pain may limp or be unable or unwilling to stand, walk, or move the affected leg. Common causes may include the following:
Toxic synovitis: It is a transient inflammatory reaction.
- This generally occurs after the child has had a cold or other upper respiratory infection.
- This is the most common cause of hip pain in children.
Slipped capital femoral epiphysis
- This occurs when the upper end of the thighbone (head of the femur) slips at the growth plate (epiphysis) and does not fit in the hip socket correctly.
Perthes disease
- Decreased blood flow to the head of the femur that affects the bone causes this condition.
Femoral anteversion: It is an inward twisting of the thighbone.
- This condition causes the knees and feet to turn inward.
- The child will have a pigeon-toed appearance and may have a clumsy walk.
Developmental dysplasia of the hip (DDH)
- A problem in the development of the hip joint causes this condition.
- The top of the femur does not fit correctly into the acetabulum (hip socket) so the femur can partially or completely slip out of the socket.
Juvenile idiopathic arthritis (JIA)
- This condition causes inflamed, swollen joints that are often stiff and painful.
Infection
- Septic arthritis (infection in the joint)
- Septic bursitis (infection of the bursa that are fluid-filled pads that act as cushions in the joint)
- Osteomyelitis (infection of the hip or pelvic bone)
Cancerous process
If your child has a problem with the hip joint, they may feel pain in the groin, down the front of the leg, and in the knee. Sometimes, knee pain is the only symptom of a hip problem. This is called referred pain or radiated pain and is fairly common. Your child may feel pain on the outside of their hip or in their buttock, although this can also be caused by problems with their lower back.
Diagnosing Hip Pain
Health care professionals diagnose hip pain with a history and physical examination. Physical examination maneuvers, such as internally and externally rotating the hip, can be used to detect pain-aggravating positions. Tenderness can be elicited by palpating over inflamed areas. Straight leg raising can detect signs of sciatica. A health care professional may use imaging studies, including X-rays, CT scans, and MRI scans, to further define the causes of hip pain. Sometimes, nuclear medicine bone scans are used to image inflamed or fractured bone.
What are treatment options for hip pain in children?
Treatment for a hip problem depends on the location, type, and severity of the problem and the child's age, general health, and activity level. Treatment options may include the following:
- First-aid measures
- Application of a brace, cast, harness, or traction
- Physiotherapy or occupational therapy
- Anti-inflammatory, painkiller, and pain-relieving medications
- Antibiotic medications
- Steroid injections
- Other therapies such as acupuncture
- Weight loss and exercises
- Stretching, strengthening exercises, or resistance training
- Water exercise including swimming
- Surgery
It can be a challenge for doctors to diagnose hip pain and limping in children. Usually, there is a very simple explanation for hip pain (for example, if your child overdid it while playing). In this case, pain is usually caused by strained or inflamed soft tissues, such as tendons, and it often clears up within a few days. If your child's hip pain doesn't improve with simple medications such as acetaminophen and ibuprofen and a mixture of rest and gentle exercises, you should see your doctor for further advice.