Hip pain (peds): Difference between revisions
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==Disposition== | ==Disposition== | ||
*Depends on diagnosis | |||
**[[Transient (toxic) synovitis]] is diagnosis of exclusion | |||
==See Also== | ==See Also== | ||
Revision as of 19:07, 8 August 2019
This page is for pediatric patients; for adult patients see hip pain
Background
- It can be difficult to differentiate hip from knee pain in children
Clinical Features
- Hip pain
Differential Diagnosis
Pediatric limp
Hip Related
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Other Causes of Limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
Evaluation
Left hip effusion[1]
Workup
- X-ray hip (AP & bilateral Frog leg), femur, knee
- Consider CBC, ESR, CRP
- Consider:
- Ultrasound to evaluate for effusion
- CT or MRI to evaluate for abscess
Kocher Criteria for septic arthritis of the hip
- ESR > 40 mm/hr
- WBC > 12,000/microliter
- Refusal or inability to weight bear on affected joint
- Fever 38.5° C or greater
| Number of Kocher Criteria | Chance of Septic Joint |
| 1 | 3% |
| 2 | 40% |
| 3 | 93% |
| 4 | 99% |
Management
- Depends on diagnosis
- Transient (toxic) synovitis is diagnosis of exclusion
Disposition
- Depends on diagnosis
- Transient (toxic) synovitis is diagnosis of exclusion