Synonyms in the broadest sense
“Hip fever”, serous coxitis, transient synovitis of the hip
Definition
The “hip cold” is a kind of inflammation of the hip joint. More precisely, it is a temporary abacterial irritation of the hip joint of children.
Occurrence of Coxitis fugax
As a rule, the affected children are under 10 years old. Boys are affected four times as often as girls. The peak of the disease is between 3 and 8 years, with both younger and older children being affected.
Both joints are affected equally often. There is therefore no tendency to one side of the body. Rarely both hip joints are affected at the same time (less than every twentieth child).
A more frequent occurrence can be observed in the early and late months of the year. In summer, however, the inflammation of the hip occurs rather rarely. A familial clustering, i.e. possibly a genetic component, has not yet been confirmed. Coxitis fugax also appears to occur independently of congenital or acquired hip joint damage.
What causes coxitis fugax?
The development of Coxitis fugax is unclear. However, it has been observed that “hip rhinitis” is preceded by a banal, viral infection usually of the upper respiratory tract or the gastrointestinal tract. Often this infection occurred about two weeks ago.
After that a joint effusion forms. Occasionally, transitions from coxitis fugax to Perthes disease are described. Hip rhinitis” is therefore not an independent disease, but always the result of an infection.
Symptoms of Coxitis fugax
The symptoms of children with coxitis fugax appear suddenly. The children usually report the pain in the groin area. The children stand out mainly by limping.
Due to the pain, the affected side is relieved. The resulting limp is called a sparing limp. Occasionally the pain of coxitis fugax also radiates into the nearby knee joint.
This fact is typical for a “hip cold” and parents should always take their children to the doctor. The general condition of the children is otherwise usually unaffected and they do not have a fever. Another characteristic of this childhood hip pain is its dependence on stress.
Therefore, they do not occur under physical restraint. In some cases, the pain can be so severe that the children do not want to walk at all or switch back to early childhood forms of locomotion such as crawling. In addition, limited mobility of the hip on the affected side is typical.
Particularly uncomfortable and painful for the affected children is a rotational movement in the hip (internal rotation), i.e. a type of movement in which the leg is only rotated by moving the hip joint. The diagnosis of coxitis fugax is mainly based on ultrasound. Ultrasound is a grateful examination method for children, as it is neither invasive nor painful and can be performed quickly.
The transducer can be placed directly on the hip joint. A widened and fluid-filled joint space can be very clearly seen in the ultrasound. The X-ray image, on the other hand, which is always associated with radiation exposure and is therefore tried to be avoided in children, does not usually show any abnormalities.
A blood sample can be taken in case of coxitis fugax, but usually shows no changes in the inflammation parameters. To diagnose coxitis fugax, the patient’s medical history, clinical examination, blood test and then ultrasound of the hip is performed – first the affected side and then the opposite side. The ultrasound examination can confirm the diagnosis of coxitis fugax.
However, if there are indications of other diseases of the hip that must be urgently excluded, an X-ray examination of the hip can be performed or, in very rare cases, an MRI, a magnetic resonance tomography. Particularly if no improvement in the course of the disease is foreseeable after 14 days, further imaging diagnostics should be carried out. – Spine
- Basin shovel (Os ilium)
- Hip joint
- Femoral head
- Femoral neck
- Symphysis
- Small rolling mound (trochanter minor)
- Large rolling mound (greater trochanter)
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