Hip Problems, Age 11 and Younger

Overview

A hip problem can be hard to deal with, both for the child who has the problem and for 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 they may develop from injury, overuse, inflammation, infection, or tumour growth.

To better understand hip problems, it may be helpful to know how the hip works. It's the largest ball-and-socket joint in the body. The thigh bone (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 doesn't 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

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 often occurs after the child has had a cold or other upper respiratory infection. It's the most common cause of hip pain in children.
• A slipped capital femoral epiphysis. This occurs when the upper end of the thigh bone (head of the femur) slips at the growth plate (epiphysis) and doesn't fit in the hip socket correctly.
• Legg-Calve-Perthes disease. It's a disorder of the head of the femur. It's caused by decreased blood flow to this area.
• An inward twisting of the thigh bone (femoral anteversion). This condition causes the knees and feet to turn inward. The child will look "pigeon-toed" and may have a clumsy walk.
• Developmental dysplasia of the hip (DDH). It's caused by a problem in the development of the hip joint. The top of the femur doesn't fit correctly into the hip socket (acetabulum). The femur can partly or completely slip out of the socket.
• Juvenile idiopathic arthritis (JIA). It causes inflamed, swollen joints that are often stiff and painful.
• Infection in the joint (septic arthritis), the bursa (septic bursitis), or the hip or pelvic bone (osteomyelitis).
• In rare cases, cancer of the bone, such as osteosarcoma.

Treatment may include first aid and using a brace, cast, harness, or traction. It may also include physiotherapy and medicines. In some cases, surgery is needed. Treatment for a hip problem depends on:

• The location and type of injury, and how bad it is.
• The child's age, general health, and activity level.

Self-Care

Try the following tips to help relieve your child's hip pain, swelling, and stiffness. If your child becomes upset or won't co-operate, don't force your child.

• Rest.

  Have your child rest and protect the affected hip. Have your child stop, change, or take a break from any activity that may be causing pain or soreness.

• For sleep, put your child on the side that doesn't have a problem.
• Avoid things that might increase swelling.

  For 48 hours, don't let your child do things that might increase swelling. These things include taking hot showers, using hot tubs, and using hot packs.

• Apply heat.

  After 48 to 72 hours, if swelling is gone, you can put heat on your child's hip. Moist heat with a hot water bottle or warm towel may feel good to your child.

• Resume normal activities.

  After 48 to 72 hours, if swelling is gone, your child can carefully do their normal activities.

• Rub the area.

  Gently massage or rub your child's hip to relieve pain and encourage blood flow. Don't massage the affected area if it causes pain.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New pain or swelling.
• New signs of infection, such as redness, warmth, or a fever.
• New numbness, tingling, or weakness.
• New pale, white, blue, or cold skin.
• Trouble bearing weight on the hip.
• Symptoms occur more often or are more severe.

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