Hip Problems, Age 11 and Younger
Hip Problems, Age 11 and Younger
A hip problem can be hard to deal with, both for the child who has
the problem and to the parent or caregiver. A child who has a hip problem may
feel pain in the hip, groin, thigh, or knee. A child in pain may limp or be
unable or unwilling to stand, walk, or move the affected leg. A baby in pain
may cry, be fussy, and have other
signs of pain. Hip problems may be present at birth
(congenital) or may develop from injury, overuse,
inflammation, infection, or tumor growth.
To better understand hip problems, it may be helpful to know how the
hip works. It is the largest ball-and-socket joint in
the body. The thighbone (femur) fits tightly into a cup-shaped socket
(acetabulum) in the pelvis. The hip joint is tighter and more stable than the
shoulder joint but it does not move as freely. The hip joint is held together
by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint
capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint
and let the tendons and muscles glide and move smoothly. The largest nerve in
the body (sciatic nerve) passes through the pelvis into the leg.
Hip problems may develop from overuse,
infection, or a problem that was present from birth (congenital). Oddly enough,
a child who has a hip problem often feels pain in the knee or thigh instead of
the hip. Hip problems that affect children include:
- An inflammatory reaction, such as
transient or toxic synovitis. 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.
- Legg-Calve-Perthes disease. This condition is caused
by decreased blood flow to the head of the femur which affects the bone as seen on the
X-ray and an MRI of a child with this problem.
- An inward twisting of
the thighbone (femoral anteversion). This condition causes the knees and feet
to turn inward. The child will have a "pigeon-toed" appearance and may have a
- Developmental dysplasia of the hip (DDH). This condition is caused by a problem in the development of the
hip joint. The top of the femur does not fit correctly into the hip socket
(acetabulum) so the femur can partially or completely slip out of the
- Juvenile idiopathic arthritis (JIA).
This condition causes inflamed, swollen joints that are often stiff and
- Infection in the joint (septic arthritis), the bursa (septic bursitis), or the hip or pelvic
- In rare cases, cancer of
the bone, such as osteosarcoma.
Treatment for a hip problem depends on the location, type,
and severity of the problem as well as the child's age, general health, and
activity level. Treatment may include first aid measures; application of a
brace, cast, harness, or traction; physical therapy; medicines; or
Check your child's symptoms to decide if and when
your child should see a doctor.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
July 30, 2012
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