Common Causes of Hip Pain in Children

Dhealthwellness.com – Hip pain in children is usually a sign of an injury or disorder. It can affect the hip, groin, or knee on the same side. A child who has pain may limp or refuse to put weight on the affected leg.

Hip Pain in Children Is a Sign of Injury

Doctors aren’t sure what causes this problem, which is most common in kids up to age 8. It can be treated with medicine or surgery. All freely movable joints in the body have a thin layer of delicate tissue that lubricates the joint and helps it move smoothly. This is called the synovial membrane. When this is inflamed, it produces more than normal fluid and causes hip pain and limping. The inflammation usually goes away within a week or two and does not cause any long-term problems. This is a common cause of hip pain in children, most often between the ages of 3 and 10. Boys are affected twice as frequently as girls.

A child with an irritable hip will complain of pain in the hip, groin, or thigh on one side. It is most commonly present on the left side of the body. Occasionally a child will also have a fever and elevated C-reactive protein and sedimentation rate (ESR and CRP). A child with these symptoms should be evaluated by a doctor immediately. Children can develop a condition called osteochondritis dissecans (OCD), which causes pain when a small piece of the bone separates from its surrounding cartilage due to a lack of blood supply. Most often, this condition occurs in the knee or ankle. However, it can also occur in the elbow. This condition is most common in boys and girls between the ages of 10 and 20.
Juvenile idiopathic arthritis (JIA)

The Immune System Mistakenly Causes Inflammation in the Joints

JIA is an autoimmune disease, meaning that the body’s immune system mistakenly creates inflammation in a joint when there is no reason to. This causes pain and stiffness. It is unknown why some children get JIA, but it is thought that genetic factors and environmental triggers play a role. Symptoms vary depending on the type of JIA, but all types cause pain, swelling, warmth and stiffness in the joints. The most common form of the condition is oligoarticular JIA, which affects four or fewer joints. JIA with a sacroiliac (SI) joint involvement is more severe and is more likely to be seen in older children and boys.

JIA treatments focus on controlling abnormal inflammation and allowing the child to live a normal life. Doctors prescribe medicines, such as nonsteroidal anti-inflammatory drugs and Disease-modifying Antirheumatic Drugs (DMARDs), to relieve symptoms and reduce joint damage. Physical therapy helps regain normal range of motion in the affected joint. A fracture of the growth plate (called an apophysis) is a common injury among children and adolescents. A growth plate injury can cause pain and a delay in bone growth. Your child may need surgery to repair the fracture.

Recommend Exercises to Strengthen Muscles

X-rays can help doctors determine the type of fracture and its location. They may also use a CT scan or an MRI to see the fractured area. Most growth plate fractures aren’t serious and heal well. The doctor may recommend a cast to immobilize the affected area and recommend exercises to strengthen muscles and improve range of motion. If the fracture is displaced, surgery is needed to realign the bone. Surgery often includes the placement of metal screws or pins to ensure proper healing. Children with fractures of the growth plate can have a long recovery process and may need to have follow-up evaluations for several years.

This is a self-limited inflammatory condition that occurs before adolescence. It is a common cause of hip pain in children. Children with this problem often complain of having pain in one hip, and some even refuse to put weight on that leg. This condition is often diagnosed by history and physical examination. However, X-rays, ultrasound or MRI may be used to help confirm the diagnosis. The hip pain that children experience with this condition is mainly due to inflammation and swelling. Most children recover completely from this condition within two weeks. Those who do not recover within this period are more prone to developing Legg-Perthes disease in the future. Children with TS are usually encouraged to reduce their activities until they get better. Taking anti-inflammatory medication can also help with the pain and discomfort that this condition causes.

Reference :

Frick, S. L. (2006). Evaluation of the child who has hip pain. Orthopedic Clinics37(2), 133-140.

Penner, M., Xie, W. Y., Binepal, N., Switzer, L., & Fehlings, D. (2013). Characteristics of pain in children and youth with cerebral palsy. Pediatrics132(2), e407-e413.

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