Hip Pain

Hip pain can be a tricky thing in kids.  Sometimes it’s hard for them to actually point to their hip and say “this hurts,” so they may point to their groin, thigh, or even knee, even though the problem arises from the hip.

One of the most common cause of hip pain in kids is synovitis (otherwise known as transient synovitis), which may come in combination with a viral illness and/or fever.  The pain comes from inflammation inside the hip joint.  This problem is not caused by a fall or trauma.  These kids are usually less than 10 years of age, and complain of hip pain, difficulty walking, and they also tend to walk with a limp.  The condition is self-limiting, meaning that it goes away on it’s own.

Even though synovitis is self-limiting, it is necessary for kids with this problem to be evaluated to make sure that they don’t have more serious hip problems that can be detrimental long term.  This means that they need an x-ray of their hip and pelvis.  Again, x-rays in kids with synovitis are normal, but they help make sure that other treatment is not needed.  Treatment is non-weightbearing (rest) and medicines like tylenol or ibuprofen until the pain resolves.

Some hip problems in kids affect their bones and may need surgery.  In older kids (around adolescence), the growth plate in the ball of the hips joint can actually slip and cause long term damage if surgery is not done immediately.  This problem is called slipped femoral capital epiphysis (or SCFE).   In young children (usually before school age) there is a condition called Perthes disease where blood flow to the hip is compromised and the ball of the hip joint is affected.

Hip pain can of course also occur with falls or trauma.  But sometimes kids aren’t the best historians and you may not witness the fall, so it could be difficult to determine if a fall or injury is causing their pain or limp.

So …  if your child limps, regardless of his or her age, make sure that they are evaluated by a pediatrician or orthopedic doctor.  If not, they could sustain long term damage and arthritis in their hip!

Rachel Brewer, MD

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