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Updated: May 8, 2026

In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Radiological approach to a child with hip pain
1Department of Radiology, University Hospital of Wales, Cardiff, UK.
Insights
Diagnosing pediatric hip pain requires careful history and examination to guide imaging. Age and clinical findings help differentiate causes, with radiography and ultrasound often being sufficient.
Area of Science:
- Pediatric Radiology
- Musculoskeletal Imaging
Background:
- Pediatric hip pain presents diagnostic challenges due to communication barriers in children.
- Causes include infective, inflammatory, traumatic, neoplastic, and developmental conditions.
Purpose of the Study:
- To review the diagnostic imaging approach for pediatric hip pain and limp.
- To illustrate common and rare hip pathologies in children.
Main Methods:
- Clinical history and physical examination are crucial for directing radiological investigations.
- Age-specific disease prevalence aids in differential diagnosis.
- Imaging modalities include plain radiography, ultrasound, MRI, and bone scintigraphy.
Main Results:
- Plain radiography and ultrasound are often adequate for initial evaluation.
- Ultrasound allows real-time imaging and guided aspiration.
- MRI and bone scintigraphy are valuable for complex cases, multifocal disease, and staging.
- Computed tomography (CT) has limited use due to radiation exposure.
Conclusions:
- A systematic approach combining clinical assessment and appropriate imaging is essential for diagnosing pediatric hip conditions.
- Imaging selection should be tailored to the child's age and clinical presentation.
Abstract:
Hip pain in a child can be a diagnostic challenge partly because of barriers to communication in the paediatric age group. Pain or limp may result from infective, inflammatory, traumatic, neoplastic, or developmental causes. A meticulous history and detailed clinical examination guide the radiological investigation in the appropriate direction. The age of the child further helps to narrow the differential as certain diseases are more common in certain age groups. In most patients plain radiograph and/or ultrasound is adequate. Ultrasound has the added advantage of being real time and can be used to guide aspiration. Magnetic resonance imaging (MRI) and bone scintigraphy can be used for problem solving, looking for multifocal disease, and staging. Computed tomography (CT) has a limited role to play because of the risks associated with ionizing radiation. In this review we discuss the approach to imaging a child who presents with pain in the hip or with a limp. The various common and rare, but important, diseases are illustrated with examples from our clinical practice.
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