Hip problems in Children

There are several important problems that affect the growing hip at all ages through childhood. Some of them are actually very serious and can lead to long term problems if not recognised and treated properly.

It is really important to know that hip problems can present as thigh or knee pain. It is really important that if your child presents with hip, thigh or knee pain that they have an examination that includes a hip assessment. If you have been seen by a healthcare professional with any of these symptoms and the hip is not examined you must request that the hip is checked too.

The major hip problems are as follows:

  • Dysplasia (DDH)
    • This is detected soon after birth and if your baby has an abnormal baby check hip examination then they will be referred for an ultrasound scan of the hip
    • If a problem is found the commonest treatment is a Pavlik harness.
    • It is vital to get proper treatment because the hip can become normal for the future but if missed this condition can lead to premature arthritis of the hip.
  • Perthes disease
    • A condition of impaired blood flow that results in pain and deformity of the hip joint. The joint needs regular specialist assessment and surgery may be needed to protect the hip joint. There is growing evidence that early surgery is associated with better outcomes in this difficult condition
  • Slipped epiphysis (SCFE)
    • Known as slipped capital femoral epiphysis this condition involves a separation of the growing part of the hip and is potentially very serious
    • It must be identified as early as possible and treated with a simple operation to prevent further slipping which could then require much more significant surgery with higher risks of serious complications
  • Snapping tendons
    • Snapping trochanter – on the outside of the upper thigh
    • Snapping iliopsoas – deep in the groin
    • These are not serious problems but can be a cause of pain
  • Irritable hip
    • This is when the lining of the hip joint becomes inflamed and the joint is painful and has restricted movements. The most common presentation is a limp. It is not serious in itself but the problem can be ruling out an infection in the hip which is serious and needs urgent treatment. ┬áIf a hip is painful with reduced movement the child must always be seen in the hospital to rule out bone or joint infection
  • Femoroacetabular impingement (FAI)
    • This condition involves pain from the front of the hip impinging between the femur and the socket (acetabulum) and is due to differences in the shape and development of the hip joint. It can be difficult to deal with and may require surgery to resolve