This is the commonest cause of hip pain or limping in a young child. The peak age group is 3-8 years. Although this is a hip condition, in about 30% of cases the pain may initially be felt in the knee or the thigh.
The underlying pathology in this condition is formation of fluid under tension (effusion) within the hip joint. The exact cause of this effusion is unknown, but viral infections, minor trauma or allergy have been implicated.
Diagnosis is usually made on clinical grounds. The affected hip is generally irritable on movement but relatively comfortable when the hip is kept in the position of flexion and abduction. Signs of sepsis such as high temperature, rapid pulse, flushing, limb swelling or erythaema are notably absent.
Best method of investigation is ultrasound of the hip to confirmed the presence of the effusion and blood tests to rule out rise in inflammatory markers. Plain radiographs of the hips is also taken to exclude rare associations such as Perthes’ disease. Radiographs may occasionally confirm presence of an effusion by showing a subtle medial joint space widening.
Treatment. Irritable hip is a benign and self-limiting condition. In most cases it spontaneously resolves within 48-72 hours. During the painful episode rest is advisable and this could be done at home. Other than anti-inflammatory drugs no other treatment is usually required.
If symptoms fail to resolve within the 48-72 hours or there is deterioration of general condition, urgent specialist review is necessary.
Joint Space Widening
Effusion In Affected Hip
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