Hip Problems, Age 11 and Younger
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 buttocks, 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 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. See an image of an 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 rheumatoid arthritis (JRA) . 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.
Use the Check Your Symptoms section to decide if and when your child should see a doctor.
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.
- Put your child on the side that does not have a problem for sleep.
- 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.
|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.
|Be sure to follow these safety tips when you use a nonprescription medicine:|
Cast care tips
If your child has a cast, see cast care tips.
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to evaluate your child's symptoms if any of the following occur during home treatment:
- Pain or swelling develops.
- Signs of infection develop.
- Numbness, tingling, or weakness develops.
- Pale, white, blue, or cold skin develops.
- Symptoms do not get better with home treatment.
- Symptoms become more severe or more frequent.
Most of the problems that can affect a child's hips or cause a child to limp cannot be prevented. The following tips can help keep your child's bones healthy and strong.
Keep bones strong
- Have your child eat a nutritious diet with enough calcium and vitamin D, which helps his or her body absorb calcium. Calcium is found in dairy products, such as milk, cheese, and yogurt; dark green, leafy vegetables, such as broccoli; and other foods.
- Have your child stay active. Play and sports are good ways for your child to exercise.
- Do not give your child caffeine, such as in soda pop. This may increase calcium loss from his or her body.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your health professional 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?
|Author||Jan Nissl, RN, BS|
|Editor||Susan Van Houten, RN, BSN, MBA|
|Associate Editor||Tracy Landauer|
|Primary Medical Reviewer||Adam Husney, MD - Family Medicine|
|Primary Medical Reviewer||Michael J. Sexton, MD - Pediatrics|
|Specialist Medical Reviewer||Steven L. Schneider, MD - Family Medicine|
|Specialist Medical Reviewer||H. Michael O'Connor, MD - Emergency Medicine|
|Last Updated||September 15, 2008|