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Missed Intra-Abdominal Foreign Bodies Presenting as Hip Pain in Children: A Report of 2 Cases

Zachary Lowe1, David A Bagley1, David Gosser1

  • 1Department of Orthopaedic Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri.

JBJS Case Connector
|February 5, 2026
PubMed

Insights

Intra-abdominal foreign bodies can cause hip pain in children. Early diagnosis is crucial, as these cases highlight missed opportunities. Prompt identification and removal lead to complete symptom resolution.

Area of Science:

  • Pediatric Surgery
  • Pediatric Orthopedics
  • Diagnostic Imaging

Background:

  • Hip pain in children can stem from various causes, including infections and musculoskeletal issues.
  • Intra-abdominal pathologies are often overlooked in the differential diagnosis of pediatric hip pain.
  • Delayed diagnosis of intra-abdominal foreign bodies can lead to significant morbidity.

Purpose of the Study:

  • To highlight the importance of considering intra-abdominal foreign bodies in pediatric patients presenting with hip pain.
  • To emphasize the diagnostic challenges and missed opportunities in two pediatric cases.
  • To underscore the need for a comprehensive evaluation in children with unexplained hip pain.

Main Methods:

  • Case report of two pediatric patients presenting with hip pain.
  • Initial orthopedic consultation for suspected infection.
  • Magnetic Resonance Imaging (MRI) to identify intra-abdominal foreign bodies.
  • Surgical removal of foreign bodies.

Main Results:

  • Two boys, aged 8 months and 10 years, presented with hip pain.
  • Intra-abdominal foreign bodies were identified via MRI after initial evaluations.
  • Both patients underwent successful surgical removal of the foreign bodies.
  • Complete resolution of hip pain and symptoms was achieved post-operatively.

Conclusions:

  • Missed opportunities for early diagnosis of intra-abdominal foreign bodies occurred in both cases.
  • Inadequate initial workup, including lack of specific imaging or physical examination, contributed to diagnostic delays.
  • Abdominal foreign bodies should be a key consideration in the diagnostic workup of pediatric hip pain and limping.
Abstract

Keywords:
MRIabdomenelevated CRPelevated ESRfeverforeign bodyhip paininfantleukocytosislimpingpediatricpelvic floorpsoasrectal painseptic hip

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