Imaging of nontraumatic acute hip pain in children: multimodality approach with attention to the reduction of medical radiation exposure

Abstract

Nontraumatic acute hip pain in children is common. However, the presentation and etiology is variable, including difficulty with weight bearing and abnormal gait. Barriers in communication, multiple possible etiologies, and age-specific anatomical variations of the pediatric hip make the evaluation of hip pain in children a difficult clinical diagnosis. Multimodality radiologic approach plays an important role for the evaluation of these children. However, owing to the complexity of pediatric hip disease, children sometimes undergo multiple radiologic examinations, resulting in delay in diagnosis and increased radiation dose. This article focuses on the illustration and discussion of common causes of acute hip pain or limp in children. Current recommendations for the imaging of these patients with specific attention to the ALARA (as low radiation as reasonably achievable) principle of radiation exposure are considered. Examples of the entities discussed are provided.