Top of the pageCheck Your Symptoms

Topic Overview

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

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.
  • A
    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
    clumsy walk.
  • 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
    socket.
  • Juvenile idiopathic arthritis (JIA).
    This condition causes inflamed, swollen joints that are often stiff and
    painful.
  • Infection in the joint (septic arthritis), the bursa (septic bursitis), or the hip or pelvic
    bone (osteomyelitis).
  • 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
surgery.

Check your child’s symptoms to decide if and when
your child should see a doctor.

Check Your Symptoms

Does your child have a hip problem?
This includes symptoms like pain, trouble moving, and differences in the hips.
Yes
Hip problem
No
Hip problem
How old are you?
Less than 1 year old
Less than 1 year
1 to 4 years
1 to 4 years
5 to 11 years
5 to 11 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Has your child injured the hip in the past month?
Yes
Hip injury in the past month
No
Hip injury in the past month
Has your child had hip surgery in the past month?
If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.
Yes
Hip surgery in past month
No
Hip surgery in past month
Does your child seem to have any hip pain?
Yes
Appears to have hip pain
No
Appears to have hip pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
5 to 10: Moderate to severe pain
Moderate to severe pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Does your child seem to have any hip pain?
Yes
Appears to have hip pain
No
Appears to have hip pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
How long has the pain lasted?
Less than 2 full days (48 hours)
Pain less than 2 days
2 days to 2 weeks
Pain 2 days to 2 weeks
More than 2 weeks
Pain more than 2 weeks
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Do you think the problem may be causing a fever?
Some bone and joint problems can cause a fever.
Yes
Possible fever
No
Possible fever
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Does your child have diabetes, a weakened immune system, or any surgical hardware in the area?
“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, or surgical hardware in affected area
No
Diabetes, immune problems, or surgical hardware in affected area
Is your child having trouble moving the hip or leg?
Yes
Difficulty moving hip or leg
No
Difficulty moving hip or leg
Is it very hard to move or somewhat hard to move?
“Very hard” means you can’t move it at all in any direction without causing severe pain. “Somewhat hard” means you can move it at least a little, though you may have some pain when you do it.
Very hard
Very hard to move
Somewhat hard
Somewhat hard to move
How long has your child had trouble moving the hip?
Less than 2 full days (48 hours)
Difficulty moving for less than 2 days
2 days to 2 weeks
Difficulty moving for 2 days to 2 weeks
More than 2 weeks
Difficulty moving for more than 2 weeks
Has the loss of movement been:
Getting worse?
Difficulty moving is getting worse
Staying about the same (not better or worse)?
Difficulty moving is unchanged
Getting better?
Difficulty moving is improving
Have you noticed any differences between the two hips?
Yes
Difference in hips
No
Difference in hips
Has your child had hip problems for more than 2 weeks?
Yes
Symptoms for more than 2 weeks
No
Symptoms for more than 2 weeks

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
    sooner.
  • Medicines you take. Certain
    medicines, herbal remedies, and supplements can cause symptoms or make them
    worse.
  • Recent health events, such as surgery
    or injury. These kinds of events can cause symptoms afterwards or make them
    more serious.
  • 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
    symptoms.
  • 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
    grimace.
  • 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
include:

  • 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
    cancer.
  • Not having a spleen.

If there is a difference between the child’s hips, you may notice that:

  • One leg looks shorter than the
    other.
  • 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
    other.

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
    ambulance unless:

    • 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.

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
    sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

  • 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.
Postoperative Problems
Hip Injuries, Age 11 and Younger
Hip Problems, Age 12 and Older

Home Treatment

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
    problem.
  • 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.
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your child’s fever or pain:

Talk to your child’s doctor before switching back and
forth between doses of acetaminophen and ibuprofen to treat a fever. When you
switch between two medicines, there is a chance your child will get too much
medicine.

Safety tips
Be sure to follow these
safety tips when you use a nonprescription medicine:
  • Carefully read and follow all labels on
    the medicine bottle and box.
  • Give, but do not exceed, the maximum
    recommended doses.
  • Do not give your child a medicine if he or she
    has had an
    allergic reaction to it in the past.
  • Do not give aspirin to anyone younger than age 20 unless directed to do so
    by your child’s doctor.
  • Do not give naproxen (such as Aleve) to children younger than age 12 unless your child’s
    doctor tells you to.

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
treatment:

  • 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
    treatment.
  • Symptoms become more severe or more frequent.

Prevention

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

  • Have your child eat
    foods rich in calcium, like yogurt, cheese, milk, and dark green vegetables. Eat foods rich in vitamin D, like eggs, fatty fish, cereal, and fortified milk.
  • Have
    your child stay active. Play and sports are good ways for your child to
    exercise.

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
    treated?
  • 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?
  • Has
    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
    help?
  • Does your child have any
    health risks that may increase the seriousness of his
    or her hip symptoms?

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine

Current as ofMarch 20, 2017

Current as of:
March 20, 2017