Childhood hip problems: Treatment, symptoms, advice and help

About hip problems in children

There are various hip problems which may be encountered in childhood, of which developmental dysplasia of hip is the commonest. Other diseased conditions of hip include Perthe’s disease, septic arthritis, transient hip synovitis and osteomyelitis of the femur.

Hip problems in children: Incidence, age and sex

Hip problems in children are quite often encountered in clinical practice. The gender bias depends upon the specific hip disorder. Developmental dysplasia of hip is more commonly seen in girls whereas transient hip synovitis and perthe’s disease is more common in boys. Developmental dysplasia of the hip is commonly seen in children of less than 5 years and perthe’s disease is seen in children younger than 10 years of age.

Signs and symptoms of hip problems in children: Diagnosis

The common clinical features of hip disorders constitute pain around hip joint coupled with restricted hip movements. Following are specific symptoms according to the diseases:

• Developmental dysplasia of the hip: Also called congenital dislocation of the hip. It is generally congenital but may also be acquired after birth in some children. This condition results from shallow sockets of hip bone in which the femur (thigh bone) head fits in to form hip joint. It is characterised by frequent hip dislocation and can affect one or both joints. Limitation of hip movements is a prominent feature.

• Legg-Calve Perthe’s disease: This is characterised by impaired blood flow to the head of thigh bone resulting in pain around the hip joint which may be transmitted to the knee. Other features include difference in length of both legs, muscle wasting in affected leg and prominent limping gait.

• Septic Arthritis: This is a bacterial infection of the hip joint characterised by fever and intense pain in the hip joint. Immediate medical attention is needed in this condition since it may destroy the joint if not treated timely.

• Transient hip synovitis: This is a common condition characterised by inflammation of joint lining and presents with mild pain around hip joint.

• Osteomyelitis of the femur: This condition is characterised by serious infection of head of the thigh bone which is one of the constituents of the hip joint. Clinical features include fever, pain and limitation of hip movements.

Causes and prevention of hip problems in children

Several causes can lead to hip problems in childhood. Family history or breech delivery may result in developmental dysplasia of the hip. Legg-calve perthe’s disease may result from lack of blood flow to the hip joint which may result from direct impinging of the bony structure upon the supplying artery or any other vascular problems. Septic arthritis may be caused by bacterial infections, most commonly staphylococcal or tubercular infections.

Hip problems in children: Complications

General complications of the hip disorders include chronic pain around the hip joint or failure to restore complete range of movement around the joint. Some affected individuals may also experience life long limping gait. Serious conditions like septic arthritis of the hip may result in complete destruction of the joint if it is not treated urgently.

Hip problems in children: Treatment

The treatment of any hip problem will include adequate rest and analgesic medications. Infections of the bone like in septic arthritis, tubercular arthritis or osteomyelitis may need long term antibiotic management. Developmental dysplasia of the hip may improve with body cast or a special harness called Pavlic harness to keep the joint in place. Sometimes surgical intervention may be advised in cases of developmental dysplasia of hip where re-shaping of joint bones is required. Surgery may also be considered in severe instances of septic arthritis or osteomyelitis to prevent joint destruction.