The clinical challenge in paediatric hip pain is to distinguish urgent conditions such as infection of the hip joint from the more common irritable hip. Transient synovitis is one of the most common causes in children over 3 years of age but it has similar early symptoms to septic arthritis.
Transient synovitis and septic arthritis are the most common causes of hip pain in young children. Hip pain may be caused by conditions unique to the growing skeleton, including Perthes’ disease, slipped capital femoral epiphysis (SCFE) and apophyseal avulsion fractures of the pelvis. The relative likelihood of the different causes of hip pain varies with age.
The most common and significant causes of hip pain in children are:
- Transient synovitis (irritable hip) peaking at 3-8 years.
- Septic arthritis – any age (peaking at 0-6 years).
- Perthes’ disease (3-12 years peaking at 5-7 years).
- SCFE (early adolescence – usually in obese children).
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