Hip Pain in Children (Irritable Hip)

Irritable hip, also known as transient synovitis, is a common cause of hip pain in children. It is characterized by inflammation of the lining of the hip joint, resulting in pain and stiffness.

Causes and Risk Factors

The exact cause of irritable hip is often unknown, but it is thought to be related to:

• Viral infections, such as a recent upper respiratory tract infection
• Bacterial infections, such as septic arthritis
• Trauma or injury to the hip joint
• Overuse or repetitive strain on the hip joint

Symptoms

Children with irritable hip may experience:

• Pain in the hip, thigh, or knee
• Stiffness or limited mobility of the hip joint
• Limping or difficulty walking
• Refusal to bear weight on the affected leg
• Fever, although this is not always present

Diagnosis

Diagnosing irritable hip involves a combination of:

• Medical history and physical examination
• Imaging studies, such as X-rays or ultrasound, to rule out other conditions like fractures or bone tumors
• Blood tests to check for signs of infection or inflammation
• Joint aspiration or arthrocentesis to analyze the fluid within the hip joint

Treatment and Management

Treatment for irritable hip typically involves:

• Rest and avoidance of activities that aggravate the condition
• Pain management with over-the-counter medications, such as acetaminophen or ibuprofen
• Physical therapy to maintain range of motion and strength in the affected hip
• In some cases, antibiotics may be prescribed if a bacterial infection is suspected

Prognosis and Complications

Irritable hip is usually a self-limiting condition, meaning it resolves on its own with rest and supportive care. However, in rare cases, complications can arise, such as:

• Septic arthritis, a bacterial infection of the joint that requires prompt medical attention
• Perthes disease, a condition characterized by avascular necrosis of the femoral head
• Slipped capital femoral epiphysis, a condition where the ball at the top of the femur slips out of place

Prevention

While it is not possible to completely prevent irritable hip, parents and caregivers can take steps to reduce the risk of developing this condition, such as:

• Encouraging regular exercise and physical activity to maintain strong muscles and joints
• Avoiding overuse or repetitive strain on the hip joint
• Ensuring proper warm-up and cool-down routines before and after sports or physical activities