Paediatric Hip Pain

Paediatric Hip Pain

Unlike in adults, hip pain in children is more often a sign of a significant condition. Whilst older children or adolescents are likely to speak up if they are in pain, it is often difficult to detect when infants or toddlers sustain an injury to the hip. Younger children have more difficulty in explaining how they feel, and this often delays accurate diagnosis following the onset of pain.

There are many reasons as to why your child is complaining of hip pain; the cause of this pain can be a result of musculoskeletal injuries, developmental conditions, and infections. Such causes include:

• Perthes disease
• Slipped Capital Femoral Epiphyses (SCFE)
• The irritable hip – Transient synovitis and septic arthritis
• Juvenile idiopathic arthritis (JIA)
• Muscle Strains and Tendinopathies
• Apophysitis and apophyseal avulsion injuries
• Bone fractures
• Bone tumours

Symptoms

As there is a great number of conditions that can cause juvenile hip pain or discomfort, the symptoms can present themselves in a wide variety of symptoms that can be broadly grouped into the following categories.

• Mechanical symptoms (joint catching, clicking, snapping, worse during or after activity).
• Systemic symptoms (fever, irritability).
• Inflammatory symptoms (morning joint stiffness).
• Neurological symptoms (weakness, altered sensation).
• Changes to the child’s gait (limp, altered weight bearing).

If these symptoms continue or worsen, your podiatrist will often recommend further investigation to ensure an accurate diagnosis.

Podiatric Intervention for hip pain:

For parents who are concerned with any of the previous information, podiatrists can thoroughly examine your child’s condition for any potential causes. These causes can vary widely, and some can be quite serious. It is therefore recommended that your child be assessed by a podiatrist to ensure that a correct diagnosis is obtained, as this will then allow the most appropriate treatment. Examining the child’s condition will involve:

• A paediatric-specific musculoskeletal assessment of the child’s lower limbs and postural alignment.
• Diagnostic imaging, including x-ray and diagnostic ultrasound, to evaluate the structures and alignment of the lower limbs, as well as the severity of the condition.

There are various treatment modalities that are used to treat hip pain based on the condition, severity, and age of the child. Following a comprehensive assessment of your child’s condition, treatment modalities can include:

• Customised foot orthotics or customised ankle-foot orthotics, to appropriately correct the child’s posture and assist in improving gait.
• Stretching and strengthening programs to improve the soft tissue structures that are involved with hip pain, to holistically treat the child’s condition.
• Focal and radial extracorporeal shockwave therapy (ESWT) to assist with pain reduction, stimulate healing, and improve joint range-of-motion.
• In severe cases of hip pain, the podiatrist may refer the child for orthopaedic surgical evaluation.

If your child or loved one is suffering from hip pain, call us to schedule an appointment with our podiatrists to have your child assessed or explore the options available for treatment.

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