Topic Overview
A hip problem can be hard to deal with, both for the child who has
the problem and to 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 may develop from injury, overuse,
inflammation, infection, or tumor growth.
To better understand hip problems, it may be helpful to know how the
hip works. It is the largest ball-and-socket joint in
the body. The thighbone (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 does not 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 generally occurs
after the child has had a cold or other upper respiratory infection. This is
the most common cause of hip pain in children.
- A
slipped capital femoral epiphysis. This occurs when
the upper end of the thighbone (head of the femur) slips at the growth plate
(epiphysis) and does not fit in the hip socket correctly.
- Legg-Calve-Perthes disease. This condition is caused
by decreased blood flow to the head of the femur which affects the bone as seen on the
X-ray and an MRI of a child with this problem.
- An inward twisting of
the thighbone (femoral anteversion). This condition causes the knees and feet
to turn inward. The child will have a "pigeon-toed" appearance and may have a
clumsy walk.
- Developmental dysplasia of the hip (DDH). This condition is caused by a problem in the development of the
hip joint. The top of the femur does not fit correctly into the hip socket
(acetabulum) so the femur can partially or completely slip out of the
socket.
- Juvenile idiopathic arthritis (JIA).
This condition 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 for a hip problem depends on the location, type,
and severity of the problem as well as the child's age, general health, and
activity level. Treatment may include first aid measures; application of a
brace, cast, harness, or traction; physical therapy; medicines; or
surgery.
Check your child's symptoms to decide if and when
your child should see a doctor.
Check Your Symptoms
Home Treatment
Home treatment may help relieve your
child's hip pain, swelling, and stiffness. If your child will cooperate, use
the following tips. If your child becomes upset or will not cooperate, do not
force your child.
- Rest. Have your child rest and protect the sore
hip. Have your child stop, change, or take a break from any activity that may
be causing pain or soreness.
- Ice will help your child's pain and
swelling. Put
ice or cold packs on the sore area immediately. Put ice on for 20 minutes
out of every hour and do this 4 or more times in the first 1 to 2 days. If your
child is cooperative, use the ice often. If your child is not cooperative, use
the ice as much as you can without struggling with your child. Wrap the ice in
a wet towel. Do not put the ice right on the skin. Take the ice off if your
child falls asleep.
- For sleep, put your child on the side that does not have a
problem.
- Gently rub your child's hip to relieve pain and
help blood flow.
- If the swelling is gone,
heat can be put on the area. Your child can carefully
begin normal activities. Moist heat with a hot water bottle, warm towel, or a
heating pad set on low may feel good to your child.
Medicine you can buy without a prescription| Try a nonprescription
medicine to help treat your child's fever or pain: |
|---|
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen to treat a fever. When you
switch between two medicines, there is a chance your child will get too much
medicine. |
Safety tips| Be sure to follow these
safety tips when you use a nonprescription medicine: |
|---|
- Carefully read and follow all labels on
the medicine bottle and box.
- Give, but do not exceed, the maximum
recommended doses.
- Do not give your child a medicine if he or she
has had an
allergic reaction to it in the past.
- Do not give aspirin to anyone younger than age 20 unless directed to do so
by your child's doctor.
- Do not give naproxen (such as Aleve) to children younger than age 12 unless your child's
doctor tells you to.
|
Cast care tips
If your child has a cast, see
cast care tips.
Symptoms to watch for during home treatment
Call your child's doctor if any of the following occur during home
treatment:
- Pain develops.
- Signs of infection develop.
- Your child does not want to bear weight on the side of the hip injury.
- Symptoms do not get better with home
treatment.
- Symptoms become more severe or more frequent.
Prevention
Most of the problems that can affect a
child's hips or cause a child to limp can't be prevented. The following tips
can help keep your child's bones healthy and strong.
Keep bones strong
- Have your child eat
foods rich in calcium, like yogurt, cheese, milk, and dark green vegetables. Eat foods rich in vitamin D, like eggs, fatty fish, cereal, and fortified milk.
- Have
your child stay active. Play and sports are good ways for your child to
exercise.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your child's condition by being prepared
to answer the following questions:
- What are your child's main symptoms? How long has
your child had symptoms?
- Has your child had this problem in the
past? If so, do you know what caused the problem at that time? How was it
treated?
- Does your child limp or complain about pain when he or she
walks? Where is the pain felt? How far can your child walk without pain? Does
the pain get better or worse as he or she continues to walk?
- Has
your child had any recent illness or fever?
- What activities make
your child's symptoms better or worse?
- What activities does your
child do? Has your child recently started a new activity?
- What home
treatment measures have you tried? Did they help?
- What prescription
or nonprescription medicines has your child taken? Did they
help?
- Does your child have any
health risks that may increase the seriousness of his
or her hip symptoms?
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
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| Specialist Medical Reviewer | H. Michael O'Connor, MD - Emergency Medicine |
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| Last Revised | July 30, 2012 |
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