Understanding and Treating Hip Pain in Children

Creator: Doctronic
Published: 2023-11-08

Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on November 8th, 2023.

Key Takeaways

Transient synovitis is the most common cause, typically affecting children 3-8 years old and resolving within 1-2 weeks with anti-inflammatory treatment and rest.
Legg-Calvé-Perthes disease occurs when blood supply to the femoral head is interrupted, most commonly in boys aged 4-10, requiring 2-4 years of treatment to prevent permanent deformity.
Slipped capital femoral epiphysis affects overweight adolescents during growth spurts, with the femoral head sliding off the neck of the thighbone—immediate surgical pinning prevents further slippage.
Developmental hip dysplasia occurs in 1-3% of newborns when the hip socket doesn't properly cover the ball portion, requiring Pavlik harness treatment for 6-12 weeks when caught early.
Any child with persistent limping for more than 48 hours, inability to bear weight, or fever accompanying joint pain requires urgent medical evaluation to rule out septic arthritis.

Hip pain is a common problem in children that can make it difficult for them to walk, crawl, sit, or stand. If your child is experiencing hip pain, they may also have pain in their knee or thigh, start to limp, or be unable to walk due to the severity of the pain. There are several reasons why your child may be experiencing hip pain, including congenital problems, infections, injuries, and other conditions.

Common Causes of Hip Pain in Children

Transient Synovitis

Transient synovitis is a common cause of hip pain in children, particularly in preschool and elementary-aged boys. Symptoms include limping, hip pain after sitting for extended periods, walking with toes pointed outward, and refusing to walk if the pain is severe. Babies with transient synovitis may cry when their hip joint is moved. This condition often occurs after a recent viral infection and can be treated with anti-inflammatory and pain medications. Most children recover within a few weeks without any long-term issues.

Hip Dysplasia

Hip dysplasia is a condition in which one or both of a baby's hips do not develop properly. It is more common in girls and may be related to hormones in the womb that relax the hips too much. Babies born in a breech position are also at a higher risk. Treatment usually involves wearing a soft brace that keeps the knees bent for several months, although surgery may be necessary in rare cases.

Arthritis

Juvenile idiopathic arthritis (JIA) is the most common type of arthritis that causes hip pain in children. Symptoms include stiffness, swelling in multiple joints, fever, and an unusual walk. The exact cause of JIA is unknown, but it may be linked to a viral infection. Treatment often involves anti-inflammatory drugs.

Understanding and Treating Hip Pain in Children

Legg-Calve-Perthes Disease

Legg-Calve-Perthes disease occurs when the rounded top of the thighbone (femoral head) does not receive enough blood supply, making it more susceptible to fractures and poor healing. This can cause limping, sudden pain in the hip, knee, or thigh. Boys under the age of 8 are more commonly affected. Treatment options include crutches, casting, physical therapy, and surgery. Children who develop this condition after age 6 are more likely to experience hip problems as adults.

Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis is a fracture along the growth plate under the ball joint in the hip, causing pain in the hip, thigh, or knee. In severe cases, the child may be unable to walk or move their leg. This condition is more common in older children and those who are overweight, with boys being more frequently affected. Surgery is a common treatment, and while many children recover fully, they are at a higher risk of developing hip arthritis as adults.

Infections

Various infections, such as septic arthritis, bacterial infections, and Lyme disease, can cause hip pain and difficulty walking in children. Septic arthritis can lead to painful hip swelling and redness, while Lyme disease is transmitted through the bite of an infected tick. Treatment may involve antibiotics or, in some cases, a procedure to drain the infection from the joint.

When to Seek Medical Attention

If your child is experiencing severe hip pain or is unable to walk, it is essential to seek medical attention immediately. Your child's doctor may recommend blood tests, X-rays, or an MRI to determine the underlying cause of the hip pain and develop an appropriate treatment plan.

In conclusion, hip pain in children can have various causes, ranging from developmental issues to infections and injuries. By understanding the common causes and symptoms of hip pain, parents can seek timely medical attention and ensure their children receive the appropriate treatment for their condition.

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The Bottom Line

Most childhood hip conditions respond well to treatment when caught early, but delays can lead to permanent joint damage and lifelong mobility issues. Any limping lasting more than two days warrants immediate medical attention to distinguish between common transient inflammation and serious conditions requiring urgent intervention. If your child is experiencing persistent hip pain or walking difficulties, Doctronic can help connect you with appropriate pediatric care quickly.