Differential Diagnosis for Pediatric Hip Pain

The following is a differential diagnosis for pediatric hip pain, categorized for clarity and emphasis on critical conditions.

• Single Most Likely Diagnosis
  • Transient Synovitis: This is the most common cause of hip pain in children, often presenting with acute onset of pain and limited mobility. It is usually self-limiting and resolves without specific treatment.
• Other Likely Diagnoses
  • Slipped Capital Femoral Epiphysis (SCFE): A condition where the ball at the upper end of the femur slips out of place, more common in obese adolescents. It presents with hip, thigh, or knee pain and requires prompt treatment to avoid long-term damage.
  • Legg-Calve-Perthes Disease: A condition characterized by the temporary loss of blood supply to the hip, leading to necrosis of the bone. It typically affects children between 4 and 8 years old and can lead to chronic hip problems if not properly managed.
  • Septic Arthritis: A bacterial infection within the joint space, which is a medical emergency requiring immediate antibiotic treatment and possible surgical intervention to prevent joint destruction.
• Do Not Miss Diagnoses
  • Malignancy (e.g., Osteosarcoma, Ewing's Sarcoma): Although rare, these conditions can present with hip pain and are critical to diagnose early for effective treatment and prognosis.
  • Osteomyelitis: An infection of the bone that can lead to severe complications if not promptly treated with antibiotics.
  • Juvenile Idiopathic Arthritis (JIA): An autoimmune condition that can cause hip pain among other symptoms, requiring early diagnosis for appropriate management to prevent long-term joint damage.
• Rare Diagnoses
  • Gaucher's Disease: A genetic disorder that can lead to bone pain, including hip pain, due to the accumulation of harmful substances within cells.
  • Multiple Epiphyseal Dysplasia: A rare genetic disorder affecting the ends of bones, leading to skeletal malformations and potential hip pain.
  • Synovial Chondromatosis: A rare condition where cartilage grows in the synovium of the joint, leading to pain and limited mobility.

Each of these diagnoses has distinct clinical features and requires a thorough medical evaluation, including history, physical examination, and often imaging studies, to accurately diagnose and manage pediatric hip pain.