Irritable hip is inflammation (swelling) of the membrane covering the hip joint. It is the most common cause of hip pain in young children.

A child with irritable hip will have pain and restricted movement in their hip joint. The pain can also spread to the thigh, groin and knee areas. This makes standing and walking difficult and causes the child to limp. Usually, only one hip is affected.

Who is affected?

Irritable hip is a common childhood condition that affects boys and girls of any age. It is most often seen in boys aged between 2 and 12, and twice as many boys than girls are affected.

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 often short lived and has no further complications. It usually goes away without treatment after one to two weeks. Complete rest during this period is usually all that is needed.

Symptoms of irritable hip 

Symptoms of irritable hip usually develop quickly, starting as strong pain and restricted movement in one of the hip joints (it is rare for both hips to be affected). In some cases, the pain can spread to the thigh, groin and knee. Walking or even standing may become very uncomfortable and the child will develop a limp. Other than these symptoms, the child is well.

The symptoms usually last for one to two weeks and then clear up just as quickly as they developed.

Causes of irritable hip 

Irritable hip is inflammation (pain and swelling) of the synovial membrane that surrounds the hip joint. It is not clear what causes it, although in some cases your child will have had a viral infection, such as a cold or sore throat, in the previous week or so. Sometimes, the condition occurs as a result of a fall or injury.

Irritable hip can also occur as a result of a more serious condition, such as Perthes disease, when the top of the thighbone softens and re-grow out of or various types of childhood arthritis

Diagnosing irritable hip 

Irritable hip is fairly simple to diagnose. Usually an explanation of the symptoms is all that is needed. Your doctor will ask your child to try to move the affected leg.

Your doctor may want to refer your child to hospital for the following tests:

• an X-ray to see if there is a problem with your child’s bones,
• blood tests to look for evidence of a bone or joint infection, or
• an ultrasound scan to create an image of the affected hip joint and detect any fluid on the joint (which can be removed and tested for a more serious infection called septic arthritis).

These tests can rule out more serious causes of your child’s symptoms and to confirm they have irritable hip.

Treating irritable hip 

Most children with irritable hip just need to take painkillers, such as paracetamol, and rest their joint for one to two weeks until it gets better. This can be done at home or in hospital.

Resting the hip

Many children with irritable hip are treated in hospital where they may be put on traction (see the box, right). Your child should only have to stay in hospital for one or two nights.

If a hospital stay is not required, it is essential that your child completely rests at home. The most comfortable and painless position is lying on the back with the knee bent outwards slightly on the painful side and the foot pointed away from the body.

Painkillers

Painkillers or anti-inflammatory drugs (called NSAIDS) for children can help relieve pain and reduce inflammation. Aspirin should not be given to children under 16 and ibuprofen should be avoided if your child has a history of asthma.

Recovery

Your child will usually fully recover within a fortnight. Your doctor will arrange a further hip X-ray about six weeks later to make sure the condition has cleared.

There are usually no complications and the condition very rarely returns. Your doctor will recommend that your child does not play sports or do any strenuous activity for at least two weeks after treatment. This is to reduce the chances of irritable hip returning.

Swimming is an excellent form of exercise to get the joint moving again.

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