Hip disorders in childhood

Disorders of the hip are encountered frequently in paediatric orthopaedic practice. They present initially to paediatricians, general practitioners and accident departments, and it is therefore important for both surgeons and generalists to have a good working knowledge of the common presentations. The challenge is to distinguish between disease processes that are benign and self-limiting (e.g. transient synovitis), acute and joint threatening (e.g. septic arthritis) or chronic and disabling (e.g. Perthes disease). This article primarily considers the epidemiology and aetiology of childhood hip diseases and provides a diagnostic framework, based upon age and risk factors. The important investigations and treatment options for each of the key differential diagnoses are also considered.