[The limping child with a painful hip].
Hip pain is a frequent cause for limping in children. Etiology work out is oriented by the age of the child, the existence of a traumatic or infectious background, the child's morphology and ethnic origin, and most of the diagnoses will require only a standard X-ray and an ultrasound to be confirmed. In this way, the three main causes to be considered in children of less than 10 years of age are septic arthritis, transient synovitis and Perthes disease. Septic arthritis will require an urgent treatment, whereas Perthes disease will need a long care and follow up in order to watch for a poor outcome that will necessitate a surgical treatment to restore containment of the femoral head. In the adolescent, especially in case of overweight, the first etiology to be considered is slipped femoral capital epiphysis, a condition that requires an early and adequate surgical treatment (in situ screw fixation), in order to avoid further displacement and femoral head deformity of poor prognosis.
Gicquel
Philippe
P
Service de Chirurgie Infantile, Hôpital de Hautepierre, Strasbourg. Philippe.Gicquel@chru-strasbourg.fr
Giacomelli
Marie-Christine
MC
Karger
Claude
C
Clavert
Jean-Michel
JM
D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001170:Arthritis, Infectious / Q000150:complications / Q000175:diagnosis; D002648:Child; D003937:Diagnosis, Differential; D005270:Femur Head / Q000473:pathology / Q000601:surgery; D005684:Gait; D006621:Hip Joint; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000150:complications / Q000175:diagnosis; D013585:Synovitis / Q000150:complications / Q000175:diagnosis