Hip Problems, Age 11 and Younger
Top of the pageCheck Your Symptoms
A hip problem can be hard to deal with, both for the child who has
the problem and to the parent or caregiver. A child who has a hip problem may
feel pain in the hip, groin, thigh, or knee. A child in pain may limp or be
unable or unwilling to stand, walk, or move the affected leg. A baby in pain
may cry, be fussy, and have other
signs of pain. Hip problems may be present at birth
(congenital) or may develop from injury, overuse,
inflammation, infection, or tumor growth.
To better understand hip problems, it may be helpful to know how the
hip works. It is the largest ball-and-socket joint in
the body. The thighbone (femur) fits tightly into a cup-shaped socket
(acetabulum) in the pelvis. The hip joint is tighter and more stable than the
shoulder joint but it does not move as freely. The hip joint is held together
by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint
capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint
and let the tendons and muscles glide and move smoothly. The largest nerve in
the body (sciatic nerve) passes through the pelvis into the leg.
Hip problems may develop from overuse,
infection, or a problem that was present from birth (congenital). Oddly enough,
a child who has a hip problem often feels pain in the knee or thigh instead of
the hip. Hip problems that affect children include:
- An inflammatory reaction, such as
transient or toxic synovitis. This generally occurs
after the child has had a cold or other upper respiratory infection. This is
the most common cause of hip pain in children.
slipped capital femoral epiphysis. This occurs when
the upper end of the thighbone (head of the femur) slips at the growth plate
(epiphysis) and does not fit in the hip socket correctly.
- Legg-Calve-Perthes disease. This condition is caused
by decreased blood flow to the head of the femur which affects the bone as seen on the
X-ray and an MRI of a child with this problem.
- An inward twisting of
the thighbone (femoral anteversion). This condition causes the knees and feet
to turn inward. The child will have a “pigeon-toed” appearance and may have a
- Developmental dysplasia of the hip (DDH). This condition is caused by a problem in the development of the
hip joint. The top of the femur does not fit correctly into the hip socket
(acetabulum) so the femur can partially or completely slip out of the
- Juvenile idiopathic arthritis (JIA).
This condition causes inflamed, swollen joints that are often stiff and
- Infection in the joint (septic arthritis), the bursa (septic bursitis), or the hip or pelvic
- In rare cases, cancer of
the bone, such as osteosarcoma.
Treatment for a hip problem depends on the location, type,
and severity of the problem as well as the child’s age, general health, and
activity level. Treatment may include first aid measures; application of a
brace, cast, harness, or traction; physical therapy; medicines; or
Check your child’s symptoms to decide if and when
your child should see a doctor.
Check Your Symptoms
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
- Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
- Try home treatment to relieve the
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Pain in children 3 years and older
- Severe pain (8 to 10): The pain
is so bad that the child can’t stand it for more than a few hours, can’t sleep,
and can’t do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and
sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Symptoms of infection may
- Increased pain, swelling, warmth, or redness in or
around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Certain health conditions and medicines weaken the immune system’s ability to fight off infection and
illness. Some examples in children are:
- Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
- Not having a spleen.
If there is a difference between the child’s hips, you may notice that:
- One leg looks shorter than the
- There are more folds of skin on the inside of one thigh than
on the other.
- One hip joint seems to move differently than the
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don’t have
one, seek care in the next hour.
- You do not need to call an
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
- You cannot travel safely either by driving
Seek Care Today
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don’t
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
Make an Appointment
Based on your answers, the problem may not improve without medical
- Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Home treatment may help relieve your
child’s hip pain, swelling, and stiffness. If your child will cooperate, use
the following tips. If your child becomes upset or will not cooperate, do not
force your child.
- Rest. Have your child rest and protect the sore
hip. Have your child stop, change, or take a break from any activity that may
be causing pain or soreness.
- For sleep, put your child on the side that does not have a
- Gently rub your child’s hip to relieve pain and
help blood flow.
- If the swelling is gone,
heat can be put on the area. Your child can carefully
begin normal activities. Moist heat with a hot water bottle or warm towel may feel good to your child.
| Try a nonprescription
medicine to help treat your child’s fever or pain:
Talk to your child’s doctor before switching back and
| Be sure to follow these
safety tips when you use a nonprescription medicine:
Cast care tips
If your child has a cast, see
cast care tips.
Symptoms to watch for during home treatment
Call your child’s doctor if any of the following occur during home
- Pain develops.
- Signs of infection develop.
- Your child does not want to bear weight on the side of the hip injury.
- Symptoms do not get better with home
- Symptoms become more severe or more frequent.
Most of the problems that can affect a
child’s hips or cause a child to limp can’t be prevented. The following tips
can help keep your child’s bones healthy and strong.
Keep bones strong
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your child’s condition by being prepared
to answer the following questions:
- What are your child’s main symptoms? How long has
your child had symptoms?
- Has your child had this problem in the
past? If so, do you know what caused the problem at that time? How was it
- Does your child limp or complain about pain when he or she
walks? Where is the pain felt? How far can your child walk without pain? Does
the pain get better or worse as he or she continues to walk?
your child had any recent illness or fever?
- What activities make
your child’s symptoms better or worse?
- What activities does your
child do? Has your child recently started a new activity?
- What home
treatment measures have you tried? Did they help?
- What prescription
or nonprescription medicines has your child taken? Did they
- Does your child have any
health risks that may increase the seriousness of his
or her hip symptoms?
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Current as ofMarch 20, 2017
Current as of:
March 20, 2017
William H. Blahd, Jr., MD, FACEP – Emergency Medicine