Hip pain (peds)

(Redirected from Hip Pain (Peds))

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

Differential Diagnosis

Pediatric hip pain

Evaluation

Left hip effusion[1]
X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation.
A normal and abnormal epiphyseal line as described by Klein et al. in an 11 year 6 month old boy with a left SCFE. Proximal prolongation of the superior neck line transects the epiphysis in the normal hip (right) but either lies flush with or does not transect the epiphysis in SCFE (left hip).

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
  • WBC > 12
  • Refusal or inability to weight bear on affected joint
  • Fever
Number of Kocher Criteria Chance of Septic Joint
1 3%
2 40%
3 93%
4 99%

Management

Disposition

See Also

References

Authors:

Ross Donaldson