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Irritable hip

Introduction

Irritable hip is a common childhood condition that causes symptoms such as hip pain and limping.

Children with irritible hip may also be reluctant to place weight on the affected hip joint, making it difficult to stand or walk. Read more about the symptoms of irritable hip.

The condition occurs when the lining that covers the hip joint becomes inflamed, although the cause of inflammation is unclear. Read more about the causes of irritable hip.

Who is affected by irritable hip?

Irritable hip can affect boys and girls of any age. However, the condition affects twice as many boys than girls. It's most often seen in boys aged 4-10.

Is it serious?

As a parent, it can be very worrying if your child is diagnosed with irritable hip and is struggling to walk. However, the condition is usually short-lived.

Most cases don't require specific treatment because the pain usually passes within two weeks.

Ibuprofen, which is available over the counter, can be used to relieve pain and reduce inflammation. Your child should also rest the affected leg until symptoms have passed. Read more about treating irritable hip.

A small number of children with irritable hip go on to have further episodes. However, these episodes usually become less frequent, then finally stop when the child is older.

When to see your GP

Although irritable hip is usually a mild condition, it's best that your GP confirms the diagnosis. This is to rule out more serious hip conditions that share some of the symptoms.

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Symptoms

The main symptom of irritable hip is pain in one of the hips. The pain isn't usually severe, but it may prevent your child from placing weight on the affected leg, and it may cause them to limp.

Occasionally, a child with irritable hip may also complain about additional pain in their knee or thigh, or restricted movement in one of the hip joints.

In younger children who are unable to speak, the only noticeable symptom may be them crying at night.

Sometimes, a child with irritable hip will have a slightly higher temperature than normal. Normal body temperature for a child is about 37ºC (98.6ºF).

When to seek medical advice

Although irritable hip is usually a mild condition, you should take your child to see their GP so that a diagnosis can be confirmed.

This is because irritable hip shares the initial symptoms of less common but more serious health conditions, such as septic arthritis, in which a joint becomes infected.

It's therefore important to rule out more serious hip conditions. Read more about diagnosing irritable hip.

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Causes

Irritable hip occurs when the synovial membrane in the hip area becomes irritated and inflamed.

All of the body's joints have a thin layer of delicate tissue that lubricates the joint and helps it to move. The layer of tissue is called the synovial membrane.

Exactly what causes the membrane to become irritated and inflamed is unclear.

Some cases of irritable hip occur after a child has had a viral infection of their chest, throat or digestive system. As a result of this, many experts think that the synovial membrane in the hip becomes inflamed as a complication of the infection. However, there is no hard evidence to support this theory.

Another theory is that a hip injury may cause the swelling, although many cases develop in children who do not have a history of injury.

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Diagnosis

Irritable hip is fairly straightforward to diagnose. Your GP will ask your child to move the affected leg and they will examine their leg and hip.

Further tests may be recommended to rule out other possible causes of your child’s symptoms, such as a hip fracture. These tests may include:

  • an X-ray to see if there's a problem with your child's bones
  • blood tests to look for evidence of a bone or joint infection
  • an ultrasound scan to create an image of the affected hip joint that will highlight any fluid that may be on the joint.  

If there's fluid on the joint, a sample can be removed and checked for an infection.

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Treatment

Most children with irritable hip can be treated at home using a combination of painkillers and bed rest.

Painkillers

The non-steroidal anti-inflammatory drug (NSAID) called ibuprofen is the painkiller that's usually recommended to treat hip pain. Ibuprofen should help to relieve pain, reduce inflammation and speed up your child’s recovery.

Do not give aspirin to children who are under 16 years old because it can trigger a serious condition called Reye’s syndrome, which can cause brain and liver damage.

Massaging the affected hip and applying heat may also help to reduce your child’s hip pain.

Bed rest

Bed rest is recommended until the symptoms of pain resolve, which usually takes around 7 to 10 days.

Hospital admission

Your child may be admitted to hospital if diagnosis is uncertain or painkillers and bed rest haven't eased the pain.

Further tests may be given to rule out an infection inside the hip joint (septic arthritis).

These tests may include:

Septic arthritis can be treated by taking antibiotics and by draining the infected fluid out of the joint.

Recovery

It usually takes a fortnight to recover from irritable hip, although your GP may recommend that your child does not play sport or take part in any strenuous activities for at least another two weeks following treatment. This is to reduce the chance of irritable hip returning.

Swimming is a good way to strengthen the joint and get it moving again.

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