Hip pain (peds)

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This page is for pediatric patients. For adult patients, see: hip pain.


  • It can be difficult to differentiate hip from knee pain in children

Clinical Features

Differential Diagnosis

Pediatric hip pain


Left hip effusion[1]
X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation.
A normal and abnormal epiphyseal line as described by Klein et al. in an 11 year 6 month old boy with a left SCFE. Proximal prolongation of the superior neck line transects the epiphysis in the normal hip (right) but either lies flush with or does not transect the epiphysis in SCFE (left hip).


  • X-ray hip (AP & bilateral Frog leg), femur, knee
  • Consider CBC, ESR, CRP
  • Consider:
    • Ultrasound to evaluate for effusion
    • CT or MRI to evaluate for abscess

Kocher Criteria for septic arthritis of the hip

  • ESR > 40 mm/hr
  • WBC > 12,000/microliter
  • Refusal or inability to weight bear on affected joint
  • Fever 38.5° C or greater
Number of Kocher Criteria Chance of Septic Joint
1 3%
2 40%
3 93%
4 99%



See Also