Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- limp
- limited range of motion at the hip joint
Other diagnostic factors
- short stature
- muscle wasting
- hyperactivity
- Trendelenburg's sign
- synovitis
- knee pain
- thigh pain
- groin/buttock pain
- asymmetric limb length
- minor trauma
Risk factors
- male sex
- age 4 to 8 years
- socio-economic deprivation
- hyper-coagulable states
- urban population
- Eskimos, Japanese, some central European races
- transient hip synovitis
- hip joint effusion
- passive smoking
- skeletal dysplasias
- congenital anomalies
- trisomy 21
- behaviour disorders
- endocrinopathy
Diagnostic investigations
Investigations to consider
- FBC
- serum ESR
- serum C-reactive protein
- bone scintigraphy
- MRI of hips
Treatment algorithm
Contributors
Authors
Consultant Orthopaedic Surgeon
Nuffield Orthopaedic Centre
Oxford
UK
Disclosures
AW declares that he has no competing interests.
Consultant Paediatric Orthopaedic Surgeon
Bristol Royal Children’s Hospital
Bristol
UK
Disclosures
DK declares that she has no competing interests.
Andrew Wainwright and Dominique Knight would like to acknowledge Jwalant S. Mehta and Sandeep Hemmadi, who wrote the original monograph and whose work is largely reflected in the current version. JSM and SH declare that they have no competing interests.
Peer reviewers
Consultant Orthopaedic and Paediatric Orthopaedic Surgeon
Llandough Hospital
Vale of Glamorgan
UK
Disclosures
PT declares that he has no competing interests.
Associate Professor of Orthopaedic Surgery
Children's Hospital
Boston
MA
Disclosures
Not declared.
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