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
- 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
- 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
- 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
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.