Your child has presented to the Emergency Department with a limp or hip/knee pain without a preceding accident or injury.
This is a common reason for children to attend and the most likely cause is a condition called “transient synovitis” or “irritable hip.” It can cause similar symptoms in a knee but the hip is more common.
There are other causes of these symptoms which your nurse practitioners or doctor will consider and investigate if required.
The following information is from the NHS website.
What causes an irritable hip?
The condition develops when the lining that covers the hip joint (the synovial membrane) becomes irritated and inflamed, although the cause of inflammation is unclear.
Some cases of irritable hip occur following a viral infection in the chest, throat or digestive system. Many experts think 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.
Who is affected?
Irritable hip can affect boys and girls of any age, but is most common between the ages of 4 and 10 years. The condition affects twice as many boys than girls.
Is it serious?
As a parent, it can be very worrying if your child is diagnosed with an irritable hip and is struggling to walk. However, the pain usually passes within two weeks and most cases don’t require specific treatment.
A small number of children with irritable hip go on to have further episodes. However, these episodes usually become less frequent and eventually stop when the child is older.
Recovery
Ibuprofen, a commonly available painkiller, can be used to relieve pain and reduce inflammation. Your child should also rest the affected leg until symptoms have passed. Massaging the affected hip and applying heat may also help to reduce your child’s hip pain.
It usually takes a couple of weeks to recover from an irritable hip, although your doctor may recommend that your child does not play sports or take part in any strenuous activities for at least another two weeks following treatment. This is to reduce the chances of irritable hip returning.
Local data suggests that there is a small probability (less than 10%) that your child’s limp is caused by a different condition. If this is the case your child may not improve in terms of pain and visible limping over the expected two weeks.
Please phone Emergency Department reception on 0131 312 0007 or 0131 312 0008 if your child still has pain or limp two weeks after you first visit the Emergency Dept.
Ask for an “ED Review Clinic Face to Face appointment”. These clinics are held on the Ground Floor of Outpatients at the main entrance to the children’s hospital.
You must return to the main Paediatric Emergency Department if:
- Your child develops a fever and still has leg pain / limp
- Your child appears unwell including vomiting, very pale, tired
- Your child develops a worsening limp such that they cannot walk or put weight through that leg
- Your child’s skin or joint(s) becomes red, swollen, hot or painful
- Your child develops severe back or genital pain
- You have significant concerns about them.
Please try to arrive in the morning (08:30 – 10:00) so there is time to arrange scans should they be required.
