Hip pain in a child: myositis or appendicitis?

Hip pain is a common presenting complaint in the pediatric emergency department, which can be attributed to many possible causes. It may be due to a benign "growing pain" or a potentially serious illness requiring urgent evaluation. At times, hip pain can be a manifestation of an underlying appendicitis in a child; thus, it can be confused with many other conditions. Children can be at particular risk for misdiagnosis or delayed diagnosis of appendicitis as it often can have an uncommon presentation with atypical signs and symptoms. Early identification, however, is important to prevent potential complications of delaying the diagnosis. We present a case that illustrates an atypical presentation of acute appendicitis. This report also highlights the diagnostic dilemma encountered during the evaluation of hip pain in children.