• Dtsch Arztebl Int · Jan 2020

    Review

    Hip Pain in Children.

    • Ayla Yagdiran, Kourosh Zarghooni, Jörg Oliver Semler, and Peer Eysel.
    • Department of Orthopedics and Trauma Surgery, University Hospital Cologne; Department of Pediatrics, University Hospital Cologne.
    • Dtsch Arztebl Int. 2020 Jan 31; 117 (5): 72-82.

    BackgroundAtraumatic hip pain in children is one of the most common symptoms with which pediatricians, orthopedists, and general practitioners are confronted, with an incidence of 148 cases per 100 000 persons per year.MethodsThis article is based on publications up to April 2019 that were retrieved by a selective search in the PubMed data- base, including case reports and reviews.ResultsInfants with fever often have purulent coxitis, which can be diagnosed by blood tests and ultrasonography. Toddlers and older children may suffer from painful restriction of motion of the hip joint, associated with limping (antalgic gait) or even the in- ability to walk. The main elements of the differential diagnosis in children aged 2-10 are coxitis fugax and idiopathic necrosis of the femoral head (Perthes disease). In children aged 10 and up, and in adolescents, slipped capital femoral epiphysis (SCFE) is typical. Bone tumors and rheumatic diseases must always be considered as well. The initial diagnostic steps on presentation of a child with restricted hip movement should be plain x-rays and joint ultrasonography for the detection of an effusion. Suspicion of a tumor is the main indication for tomographic imaging (computed tomography or magnetic resonance imaging).ConclusionThe underlying cause of hip pain in children should be diagnosed early to avoid adverse sequelae.

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