The table below provides a brief summary of the potential causes of hip problems in children
| Condition | Notes |
|---|---|
| Development dysplasia of the hip | Often picked up on newborn examination |
| Barlow's test, Ortolani's test are positive | |
| Unequal skin folds/leg length | |
| Transient synovitis (irritable hip) | Typical age group = 2-10 years |
| Acute hip pain associated with viral infection | |
| Commonest cause of hip pain in children | |
| Perthes disease | Perthes disease is a degenerative condition affecting the hip joints of children, typically between the ages of 4-8 years. It is due to avascular necrosis of the femoral head |
| Perthes disease is 5 times more common in boys. Around 10% of cases are bilateral | |
| Features | |
| • hip pain: develops progressively over a few weeks | |
| • limp | |
| • stiffness and reduced range of hip movement | |
| • x-ray: early changes include widening of joint space, later changes include decreased femoral head size/flattening | |
| Slipped upper femoral epiphysis | Typical age group = 10-15 years |
| More common in obese children and boys | |
| Displacement of the femoral head epiphysis posteroinferiorly | |
| Bilateral slip in 20% of cases | |
| May present acutely following trauma or more commonly with chronic, persistent symptoms | |
| Features | |
| • knee or distal thigh pain is common | |
| • loss of internal rotation of the leg in flexion | |
| Juvenile idiopathic arthritis (JIA) | Preferred to the older term juvenile chronic arthritis, describes arthritis occurring in someone who is less than 16 years old that lasts for more than three months. Pauciarticular JIA refers to cases where 4 or less joints are affected. It accounts for around 60% of cases of JIA |
| Features of pauciarticular JIA | |
| • joint pain and swelling: usually medium sized joints e.g. knees, ankles, elbows | |
| • limp | |
| • ANA may be positive in JIA - associated with anterior uveitis | |
| Septic arthritis | Acute hip pain associated with systemic upset e.g. pyrexia. Inability/severe limitation of affected joint |