From the Guidelines
Hip bursitis in a 9-year-old girl should initially be treated with rest, ice, and over-the-counter pain relievers like ibuprofen (5-10 mg/kg every 6-8 hours with food) or acetaminophen (10-15 mg/kg every 4-6 hours) for pain and inflammation. The child should temporarily reduce activities that worsen pain, particularly those involving repetitive hip movements or pressure on the affected area. Apply ice to the painful hip area for 15-20 minutes several times daily, especially after activity. Gentle stretching exercises focusing on the hip flexors, iliotibial band, and gluteal muscles can help once acute pain subsides. If symptoms persist beyond 1-2 weeks despite these measures, consult a pediatrician who may recommend physical therapy or further evaluation, such as radiographs or MRI, as suggested by 1 and 1.
Some key points to consider in the diagnosis and treatment of hip bursitis in children include:
- The condition often results from overuse, particularly in active children involved in sports like running, soccer, or dance 1.
- Initial treatment should focus on nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics, as recommended by 1.
- Pharmacological treatments, such as acetaminophen or ibuprofen, should be considered if nonpharmacological approaches are ineffective, with the goal of using the least risky medication first, as suggested by 1.
- Imaging modalities, such as radiographs, MRI, or ultrasound, may be necessary to evaluate the hip joint and surrounding soft tissues, as discussed in 1, 1, and 1.
- Diagnostic and therapeutic injections, such as intra-articular injections, may be useful in confirming the diagnosis and providing short-term pain relief, as mentioned in 1 and 1.
It is essential to prioritize the child's safety and well-being, and to consult a pediatrician if symptoms persist or worsen over time, to rule out other conditions like juvenile arthritis or hip disorders more common in growing children.
From the Research
Diagnosis of Hip Bursitis
- Hip bursitis, also known as greater trochanteric pain syndrome (GTPS), is characterized by chronic pain overlying the lateral aspect of the hip 2.
- Symptoms consist of persistent pain in the lateral hip radiating along the lateral aspect of the thigh to the knee and occasionally below the knee and/or buttock 2.
- Physical examination reveals point tenderness in the posterolateral area of the greater trochanter 2.
- Magnetic resonance imaging (MRI) may show an abnormal signal within the tendon of gluteus medius and fluid within the trochanteric bursa 3.
Treatment of Hip Bursitis
- Most cases of GTPS are self-limited with conservative measures, such as physical therapy, weight loss, nonsteroidal anti-inflammatory drugs, and behavior modification, providing resolution of symptoms 2.
- Other treatment modalities include bursa or lateral hip injections performed with corticosteroid and local anesthetic 2.
- Low-energy shock-wave therapy (SWT) has been found to be superior to other nonoperative modalities in some studies 4.
- Surgical interventions, such as bursectomy, longitudinal release of the iliotibial band, proximal or distal Z-plasty, osteotomy, and repair of gluteus medius tears, may be necessary in refractory cases 4, 3.
- For a 9-year-old female, the treatment approach may involve a combination of conservative measures, such as physical therapy and nonsteroidal anti-inflammatory drugs, with the goal of resolving symptoms and avoiding surgical intervention whenever possible. However, the specific treatment plan would depend on the individual case and the severity of symptoms.
Specific Considerations for a 9-Year-Old Female
- The diagnosis and treatment of hip bursitis in a 9-year-old female would require consideration of the individual's age, medical history, and the severity of symptoms.
- A thorough physical examination and diagnostic imaging, such as MRI, may be necessary to confirm the diagnosis and rule out other potential causes of hip pain.
- The treatment plan would likely involve a multidisciplinary approach, including physical therapy, pain management, and potentially orthopedic consultation.