Hip Pain - Children

When to refer

Refer all children early

Please remember that a limp, groin pain or refusal to walk or weight bear may be the first feature of hip pain - Mr David Smith has extensive expertise in this area

Differential diagnosis includes

1. Irritable hip
2. Perthes' disease
3. Slipped upper femoral epiphysis
4. Infection of the hip - these requires immediate referral if suspected. May be presenting feature of childhood malignancy especially haematological.
5. Juvenile Chronic arthitis -refer rheumatology
6. Transient synovitis of childhood

Investigations

None are required before referral

First line management

Management will depend on diagnosis which will require referral

Special points

1. Hip radiographs may show changes late and should not be used to reassure patients if clinical examination reveals likely pathology.
2. Ulrasound scan is often helpful to assist diagnosis.

Document Information
Expiry Date: 11/04/04
Author: Kennedy Tom Dr and Smith D Mr
Organisation: Arrowe Park Hospital