Is your baby limping? He could have Coxalgia
Coxalgia in children scares parents a lot because they see their puppy feel pain and move with difficulty, but in the vast majority of cases this pathology disappears in a short time, from seven to ten days, without consequences. It is therefore not the case to panic if your child limps suddenly, for no apparent reason, because he feels pain in the thigh, groin or knee: it is probable that it is an altogether harmless reactive synovitis of the hip, called in the jargon "cold of the" hip. Obviously, a medical examination is still necessary to have a precise diagnosis (and to avoid the possibility, albeit remote, of more serious and dangerous diseases) and to receive the appropriate therapies. "is coxalgia in children, what are the symptoms and causes, how long it lasts and how is it treated.
What is coxalgia that affects children?
Childhood coxalgia or reactive synovitis of the hip is an inflammatory process of the hip that causes pain especially in the anterior part of the thigh and knee due to irritation of the obturator nerve. It mainly affects children between the ages of 3 and 10 and male (the ratio of males to females is 2: 1). Usually synovitis is unilateral (affects only one leg), more rarely bilateral. Coxalgia in children is diagnosed through the "Thomas maneuver" (a test of the hip flexors which is performed directly by the pediatrician) and possibly confirmed by an "ultrasound. For children after 5 years, an x-ray of the pelvis may also be useful. The ultrasound and radiography are used to exclude that pain and the consequent lameness are due to more important causes such as Perthes disease, a necrotic degenerative process, due to poor bone vascularization, which compromises growth of the upper extremity of the femur and for which more in-depth care is required.
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Coxalgia in children: symptoms and causes of reactive synovitis of the hip
Children feel the first symptoms of coxalgia especially upon awakening, when without any warning they accuse acute pain in the groin area, due to the presence of an effusion inside the joint cavity that involves a loss of movement of the hip, the relative lameness and in some cases it even prevents you from putting your foot on the ground. As already mentioned, the painful symptoms can manifest themselves in the inner part of the thigh, in the groin or in the knee. In children with transient synovitis, the hip tends to remain flexed, rotated outwards and in abduction. It is not uncommon for the body temperature to rise.
The causes of coxalgia in children are not definitively known, but medicine is oriented on viral origin: numerous studies have in fact found that 70% of children affected by the disease had a "bronchial tract infection with fever in the previous two weeks." Much less frequent cases of coxalgia due to small lesions or to the intake of a certain drug, while vice versa there may be familiarity or predisposition to this type of disease.
How long does coxalgia that makes children limp last?
After talking about the symptoms and causes, let's find out how long coxalgia lasts in children. Case histories say that if appropriate therapies are undertaken, the pain generally resolves in 7 to 10 days, while the joint effusion disappears completely in 2 to 3 weeks. This means that even when the child no longer feels pain, it is necessary to continue the rest for some time to avoid joint pain. However, if the child regularly carries out high impact sports activities on the hip, he must wait at least to resume them. 6 weeks. In the event that the symptoms and the effusion last more than a month, it is advisable to perform further instrumental tests to exclude different or more serious pathologies.
Important: reactive synovitis of the hip has a tendency to recur (approximately in one case out of seven) both in the same limb already affected and in the other, usually within a year. the same treatment performed during the first episode, but if the frequency of relapses were to prove excessive, a significant modification of the child's sporting activity could be necessary up to 12 or 13 years.
Coxalgia in children: treatments include rest and anti-inflammatory drugs
No special treatments are necessary for coxalgia in children: the pain disappears in a short time with absolute rest or, on the recommendation of the pediatrician, with the administration of mild anti-inflammatory drugs such as tachipirina or similar to reduce inflammation more quickly and swelling of the hip. In the initial acute phase the load on the affected leg must obviously be limited and we must not worry if the child tends to keep the limb rotated outwards and flexed, a seemingly unnatural position: in reality it is absolutely normal that he does it because in this way find more comfort and feel less pain. The pediatrician can also recommend the use of Canadian sticks for the first two weeks, while the use and choice of special shoes for the child is not required.
These indications are valid if treatments for hip synovitis are regularly effective. However, if after 10 days the pain has not yet completely disappeared, it is advisable to subject the child to more careful examinations to exclude other causes due to more serious and dangerous pathologies (the aforementioned Perthes disease or fractures, septic arthritis of the hip and bone tumors) that must be diagnosed in time to avoid serious complications.
