Hip pain (peds)

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Work-Up

1) Xray knee-hip

2) Consider CBC, Sed rate

3) Consider US (vs. CT)


DDx

SEPTIC ARTHRITIS

Age - 6 mo to 8 yrs

Pres - Pain, Pseudoparalysis

Labs - ESR > 20 after 1-2 d, WBC >

Xrays - possible effusion


SLIPPED CAPITAL FEMORAL EPIPHYSIS (SCFE)

Age - 9 to 16 yrs

Present - mild to severe pain, limp

Labs - normal

Xray - Anterior displacement of femoral neck to head


LEGG-CALVE-PERTHES DISEASE

Age - 4 to 9 yrs

Present - Painless Limp

Labs - normal

Xrays - Compression, collapse, fragmentation


ACUTE TRANSIENT SYNOVITIS

Diagnosis of Exclusion

- Age 3 to 8 yrs

- Present - Pain. Limp, refusal to bear weight

- Labs nl

- Xray normal


See Also

Peds: Acute Transient Synovitis

Peds: Legg Calve Perthes Disease

Peds: Slipped Capital Femoral Epiphysis (SCFE)

Peds: Septic Arthritis


Source

Resident & Staff Physician, July 02

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