Thinking Beyond the Hip: A Clinico-Radiological Approach to Atypical Paediatric Hip Pain for the Generalist

Paediatric hip pain is a common clinical presentation and can be caused by a wide range of aetiologies, many of which are uniquely related to the growing immature skeletal system such as developmental hip dysplasia, Perthes disease and slipped capital femoral epiphysis. However, atypical or referred causes of hip pain often require a broader diagnostic approach beyond the hip joint itself, and can pose diagnostic challenges for clinicians. This article aims to provide a comprehensive review from an imaging perspective, highlighting common pathologies outside the hip that can also present with similar symptoms, including important pelvic, abdominal, and neoplastic pathologies, which are discussed. By expanding the diagnostic spectrum, we aim to improve the accuracy and timeliness of diagnosis and management in children with atypical causes of hip pain.