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Pediatric Hip Pain

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A Case-Based Approach to Hip Pain

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Abstract

Pediatric hip pain is a common condition with multiple etiologies including developmental conditions, inflammatory or infectious causes, vascular abnormality, musculoskeletal overuse, and infiltrative disease. Causes of hip pain vary from those seen in the adult population and commonly including developmental dysplasia of the hip, transient synovitis, septic arthritis, osteomyelitis, juvenile idiopathic arthritis, chondrolysis, avascular necrosis, Legg-Calve-Perthes disease, slipped capital femoral epiphysis, avulsion fracture, coxa saltans, traumatic hip dislocation, and neoplastic infiltration with prevalence varying with age of onset and presentation dependent on diagnosis. In children, timely diagnosis and appropriate treatment is paramount to prevent irreversible complications that can impair bony development or compromise function.

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References

  1. Kim HKW, Herring JA. Developmental dysplasia of the hip. In: Herring JA, editor. Tachdjian’s pediatric orthopaedics: from the Texas Scottish Rite Hospital for Children. 6th ed. Elsevier; 2022. p. 422–526.

    Google Scholar 

  2. Neville DNW, Zuckerbraun N. Pediatric nontraumatic hip pathology. Clin Pediatr Emerg Med. 2016;17:13–28.

    Article  Google Scholar 

  3. Palsson A, Kostogiannis I, Ageberg E. Combining results from hip impingement and range of motion tests can increase diagnostic accuracy in patients with FAI syndrome. Knee Surg Sports Traumatol Arthrosc. 2020;28(10):3382–92.

    Article  Google Scholar 

  4. Gibson ME, Stork N. Gait disorders. Prim Care. 2021;48(3):395–415.

    Article  Google Scholar 

  5. Rerucha CM, Dickison C, Baird DC. Lower extremity abnormalities in children. Am Fam Physician. 2017;96(4):226–33.

    Google Scholar 

  6. Maupin JJ, Steinmetz G, Thakral R. Management of femoroacetabular impingement syndrome: current insights. Orthop Res Rev. 2019;11:99–108.

    Google Scholar 

  7. Krabak B, Sussman W, Byrd JWT. Physical examination of the pelvis and hip. In: Malanga GA, Mautner K, editors. Musculoskeletal physical examination: an evidence-based approach. 2nd ed. Philadelphia: Elsevier; 2017. p. 145–72.

    Google Scholar 

  8. Schroeder PB, Nicholes MA, Schmitz MR. Hip injuries in the adolescent athlete. Clin Sports Med. 2021;40(2):385–98.

    Article  Google Scholar 

  9. Murphy KP, Sobus KML, Moberg-Wolff E, Dubon ME, Pico EL. History and physical examination. In: Murphy KP, McMahon MA, Houtrow AJ, editors. Pediatric rehabilitation. New York: Springer Publishing Company; 2020. p. 1–10.

    Chapter  Google Scholar 

  10. Banaszkiewicz PA, Huntley JS, Alshryda S. Hip. In: Paediatric orthopaedics: an evidence-based approach to clinical questions. Cham: Springer; 2017.

    Google Scholar 

  11. Murphy KP, Sobus KML, Moberg-Wolff E, Dubon ME, Pico EL. Musculoskeletal conditions. In: Murphy KP, McMahon MA, Houtrow AJ, editors. Pediatric rehabilitation. New York: Springer Publishing Company; 2020. p. 371–409.

    Chapter  Google Scholar 

  12. Zbojniewicz AM, Borders HL. The pediatric hip. Semin Roentgenol. 2021;56(3):212–27.

    Article  Google Scholar 

  13. Graf R. The diagnosis of congenital hip-joint dislocation by the ultrasonic compound treatment. Arch Orthop Trauma Surg. 1980;97(2):117–33.

    Article  CAS  Google Scholar 

  14. Graf R. Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg. 1984;102(4):248–55.

    Article  CAS  Google Scholar 

  15. Narayanan U, Mulpuri K, Sankar WN, Clarke NM, Hosalkar H, Price CT, et al. Reliability of a new radiographic classification for developmental dysplasia of the hip. J Pediatr Orthop. 2015;35(5):478–84.

    Article  Google Scholar 

  16. Herring JA, Punaro M. Arthritis. In: Herring JA, editor. Tachdjian’s pediatric orthopaedics: from the Texas Scottish Rite Hospital for Children. 6th ed. Elsevier; 2022. p. 928–44.

    Google Scholar 

  17. Uziel Y, Butbul-Aviel Y, Barash J, Padeh S, Mukamel M, Gorodnitski N, et al. Recurrent transient synovitis of the hip in childhood. Long-term outcome among 39 patients. J Rheumatol. 2006;33(4):810–1.

    Google Scholar 

  18. Caird MS, Flynn JM, Leung YL, Millman JE, D’Italia JG, Dormans JP. Factors distinguishing septic arthritis from transient synovitis of the hip in children. A prospective study. J Bone Joint Surg Am. 2006;88(6):1251–7.

    Article  Google Scholar 

  19. Sultan J, Hughes PJ. Septic arthritis or transient synovitis of the hip in children: the value of clinical prediction algorithms. J Bone Joint Surg Br. 2010;92(9):1289–93.

    Article  CAS  Google Scholar 

  20. Weber-Chrysochoou C, Corti N, Goetschel P, Altermatt S, Huisman TA, Berger C. Pelvic osteomyelitis: a diagnostic challenge in children. J Pediatr Surg. 2007;42(3):553–7.

    Article  Google Scholar 

  21. Batthish M, Feldman BM, Babyn PS, Tyrrell PN, Schneider R. Predictors of hip disease in the systemic arthritis subtype of juvenile idiopathic arthritis. J Rheumatol. 2011;38(5):954–8.

    Article  Google Scholar 

  22. Ravelli A. Diagnosis. In: Handbook of juvenile idiopathic arthritis. Cham: Springer International Publishing; 2016. p. 35–57.

    Google Scholar 

  23. Sinha P, Khedr A, McClincy MP, Kenkre TS, Novak NE, Bosch P. Epiphyseal translation as a predictor of avascular necrosis in unstable slipped capital femoral epiphysis. J Pediatr Orthop. 2021;41(1):40–5.

    Article  Google Scholar 

  24. Kim HKW, Herring JA. Legg-Calve-Perthes disease. In: Herring JA, editor. Tachdjian’s pediatric orthopaedics: from the Texas Scottish Rite Hospital for Children. 6th ed. Elsevier; 2022. p. 527–80.

    Google Scholar 

  25. Koop S, Quanbeck D. Three common causes of childhood hip pain. Pediatr Clin N Am. 1996;43(5):1053–66.

    Article  CAS  Google Scholar 

  26. Karkenny AJ, Tauberg BM, Otsuka NY. Pediatric hip disorders: slipped capital femoral epiphysis and Legg-Calve-Perthes disease. Pediatr Rev. 2018;39(9):454–63.

    Article  Google Scholar 

  27. Katz DA. Slipped capital femoral epiphysis: the importance of early diagnosis. Pediatr Ann. 2006;35(2):102–11.

    Article  Google Scholar 

  28. Reynolds RA. Diagnosis and treatment of slipped capital femoral epiphysis. Curr Opin Pediatr. 1999;11(1):80–3.

    Article  CAS  Google Scholar 

  29. Thornton MD, Della-Giustina K, Aronson PL. Emergency department evaluation and treatment of pediatric orthopedic injuries. Emerg Med Clin North Am. 2015;33(2):423–49.

    Article  Google Scholar 

  30. Maranho DA, Bixby S, Miller PE, Novais EN. A novel classification system for slipped capital femoral epiphysis based on the radiographic relationship of the epiphyseal tubercle and the metaphyseal socket. JB JS Open Access. 2019;4(4):e0033.

    Article  Google Scholar 

  31. Guzzanti V, Falciglia F. Slipped capital femoral epiphysis: comparison of a roentgenographic method and computed tomography in determining slip severity. J Pediatr Orthop. 1991;11(1):6–12.

    Article  CAS  Google Scholar 

  32. Cohen MS, Gelberman RH, Griffin PP, Kasser JR, Emans JB, Millis MB. Slipped capital femoral epiphysis: assessment of epiphyseal displacement and angulation. J Pediatr Orthop. 1986;6(3):259–64.

    Article  CAS  Google Scholar 

  33. Lalaji A, Umans H, Schneider R, Mintz D, Liebling MS, Haramati N. MRI features of confirmed “pre-slip” capital femoral epiphysis: a report of two cases. Skelet Radiol. 2002;31(6):362–5.

    Article  CAS  Google Scholar 

  34. Huntoon E, Louise K, Caldwell M. Lower limb pain and dysfunction. In: Cifu DX, editor. Braddom’s physical medicine and rehabilitation. 6th ed. Philadelphia: Elsevier; 2021. p. 727–47.e4.

    Chapter  Google Scholar 

  35. Sanders TG, Zlatkin MB. Avulsion injuries of the pelvis. Semin Musculoskelet Radiol. 2008;12(1):42–53.

    Article  Google Scholar 

  36. Metzmaker JN, Pappas AM. Avulsion fractures of the pelvis. Am J Sports Med. 1985;13(5):349–58.

    Article  CAS  Google Scholar 

  37. Palmer AJR, Ayyar Gupta V, Fernquest S, Rombach I, Dutton SJ, Mansour R, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. BMJ. 2019;364:l185.

    Article  Google Scholar 

  38. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012–8.

    Article  CAS  Google Scholar 

  39. Clohisy JC, Knaus ER, Hunt DM, Lesher JM, Harris-Hayes M, Prather H. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(3):638–44.

    Article  Google Scholar 

  40. Griffin DR, Dickenson EJ, O’Donnell J, Agricola R, Awan T, Beck M, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50(19):1169–76.

    Article  CAS  Google Scholar 

  41. Ratzlaff C, Simatovic J, Wong H, Li L, Ezzat A, Langford D, et al. Reliability of hip examination tests for femoroacetabular impingement. Arthritis Care Res (Hoboken). 2013;65(10):1690–6.

    Google Scholar 

  42. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540–52.

    Article  Google Scholar 

  43. Dwyer T, Whelan D, Shah PS, Ajrawat P, Hoit G, Chahal J. Operative versus nonoperative treatment of femoroacetabular impingement syndrome: a meta-analysis of short-term outcomes. Arthroscopy. 2020;36(1):263–73.

    Article  Google Scholar 

  44. Zogby AM, Bomar JD, Johnson KP, Upasani VV, Pennock AT. Nonoperative management of femoroacetabular impingement in adolescents: clinical outcomes at a mean of 5 years: a prospective study. Am J Sports Med. 2021;49(11):2960–7.

    Article  Google Scholar 

  45. Fredericson M, Jennings F, Beaulieu C, Matheson GO. Stress fractures in athletes. Top Magn Reson Imaging. 2006;17(5):309–25.

    Article  Google Scholar 

  46. Allen WC, Cope R. Coxa saltans: the snapping hip revisited. J Am Acad Orthop Surg. 1995;3(5):303–8.

    Article  CAS  Google Scholar 

  47. Reich MS, Shannon C, Tsai E, Salata MJ. Hip arthroscopy for extra-articular hip disease. Curr Rev Musculoskelet Med. 2013;6(3):250–7.

    Article  Google Scholar 

  48. Deslandes M, Guillin R, Cardinal E, Hobden R, Bureau NJ. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol. 2008;190(3):576–81.

    Article  Google Scholar 

  49. Figueras Coll G, Torrededia Del Rio L, Garcia Nuno L, Burniol JR, Huguet CR. Traumatic hip dislocation in childhood. Hip Int. 2010;20(4):524–8.

    Article  Google Scholar 

  50. Sink E, Kim Y. Fractures and traumatic dislocations of the hip in children. In: Weinstein SL, Flynn J, editors. Lovell and Winter’s pediatric orthopaedics, vol. 2. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2014. p. 954–83.

    Google Scholar 

  51. Archer JE, Balakumar B, Odeh A, Bache CE, Dimitriou R. Traumatic hip dislocation in the paediatric population: a case series from a specialist centre. Injury. 2021;52(12):3660–5.

    Article  Google Scholar 

  52. Hung NN. Traumatic hip dislocation in children. J Pediatr Orthop B. 2012;21(6):542–51.

    Article  Google Scholar 

  53. May CJ, Bixby SD, Anderson ME, Kim YJ, Yen YM, Millis MB, et al. Osteoid osteoma about the hip in children and adolescents. J Bone Joint Surg Am. 2019;101(6):486–93.

    Article  Google Scholar 

  54. Hewitt HR, Fugok KL, Greenberg MR, Miller AC, Abraham MG, Mazzaccaro RJ. Neuroblastoma presenting as hip pain and skull prominence in a child. Radiol Case Rep. 2019;14(11):1427–31.

    Article  Google Scholar 

  55. Petrone A-M, Macadon M, Burnei G, Gavriliu S, Ghita R. The multidisciplinary approach in a case of pediatric Ewing’s sarcoma. J Surg Service. 2016;3(2):96–9.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA

    Kayla Williams & Stephanie Tow

  2. Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA

    Onyinyechi Chidomere

Authors
  1. Kayla Williams
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  2. Onyinyechi Chidomere
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  3. Stephanie Tow
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Correspondence to Kayla Williams .

Editor information

Editors and Affiliations

  1. Physical Medicine and Rehabilitation, Sports Medicine, Peachtree Spine and Sports Physicians, Atlanta, GA, USA

    Jasmine H. Harris

  2. Princeton Spine and Joint Center, Princeton, NJ, USA

    Grant Cooper

  3. Sports MedicineDepartment of Rehabilitation and Human Performance, Mount Sinai Health System, New York, NY, USA

    Joseph E. Herrera

  4. Princeton Spine and Joint Center, Princeton, NJ, USA

    Ana Bracilovic

  5. Princeton Spine and Joint Center, Princeton, NJ, USA

    Arth Patel

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Williams, K., Chidomere, O., Tow, S. (2022). Pediatric Hip Pain. In: Harris, J.H., Cooper, G., Herrera, J.E., Bracilovic, A., Patel, A. (eds) A Case-Based Approach to Hip Pain. Springer, Cham. https://doi.org/10.1007/978-3-031-17154-3_6

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  • DOI: https://doi.org/10.1007/978-3-031-17154-3_6

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-031-17154-3

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