Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).
- Hip dysplasia (maldevelopment of the acetabulum).
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Rickets – disorder of bone metabolism in children leading to marked demineralization of bone (“bone softening”) and skeletal changes due to retardation of bone growth.
Cardiovascular system (I00-I99).
- Rheumatic fever – specific reaction that occurs after infection with serogroup A streptococci and leads to arthritides (inflammation of joints), inflammation of the heart such as peri/myocarditis (pericarditis/heart muscle inflammation), and CNS involvement in the form of chorea minor (neurologic autoimmune disease, characterized by hyperkinesias (involuntary movements), muscle hypotonia (lack of muscle strength and tone), and hyporeflexia (decreased ability to trigger a reflex)).
Infectious and parasitic diseases (A00-B99).
- Acute viral infection, unspecified (with arthralgia/joint pain).
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).
- Appendicitis (inflammation of the appendix) or other causes of abdominal pain.
Musculoskeletal system and connective tissue (M00-M99).
- Acute osteomyelitis (bone marrow inflammation).
- Autoimmune diseases – such as systemic lupus erythematosus (SLE) or dermatomyositis.
- Purulent arthritis (inflammation of the joints)
- Epiphysiolysis capitis femoris (femoral head dislocation); affected are mainly boys in puberty (about > 9 years of age); ratio of boys to girls is about 3: 1
- Coxitis fugax (“hip cold“) – non-infectious inflammation of the hip joint with spontaneous healing; for diagnosis: X-ray: structural disorder of the femoral head; sonography: effusion; inflammatory parameters (eg CRP): negativeThe disease is self-limiting; mean duration of symptoms about 5 days, in protracted course, this can be up to 14 days.
- Coxitis (hip joint inflammation), unspecified; native hip joint infection or periprosthetic infection (PPI; see “Operations” below); risk factors: Obesity, diabetes mellitus, malignancies (cancers), rheumatoid arthritis, revision arthroplasty, and immunosuppression (suppression of the immune system); symptomatology: Local signs of inflammation (swelling, redness or hyperthermia) (can occur at any age; but preferably in infants or young children < 4 years)Most common differential diagnoses in infants and children (2 to 10 years) with coxitis are coxitis fugax and idiopathic necrosis of the femoral head (Perthes disease).
- Femoral head necrosis (actually incorrect: femoral head necrosis) – disease characterized by death of part of the bony head of the femur. (possibly drug-induced).
- Hip dislocation – dislocation of the femoral head.
- Juvenile idiopathic arthritis (JIA, older synonyms: juvenile rheumatoid arthritis (JRA), juvenile chronic arthritis), oligoarticular (simultaneous inflammation of 2 to 4 joints).
- Perthes disease – aseptic bone necrosis (necrosis (tissue death) of bones occurring in the absence of infection (“aseptic”) due to an inadequate supply of blood (ischemia)) of the caput femoris (femoral head; head of femur) occurring in childhood; clinical picture: physical examination reveals painfully limited internal rotation ability (internal rotation: When a direction of rotation faces inward when viewed from the front) of the hip, reduced abduction (moving a body part away from the body axis) in hip extension, and a right-sided positive Drehmann sign (present when 90° flexion in the hip joint is possible only with abduction and external rotation of the leg)
- Osteochondrosis dissecans – circumscribed aseptic bone necrosis below the articular cartilage, which may end with the rejection of the affected bone area with the overlying cartilage as a free joint body (joint mouse).
- Osteomyelitis (inflammation of the bone marrow), acute.
- Scoliosis – sideways bent spine.
- Transitory synovitis – temporary inflammation of the synovial membrane.
Neoplasms – tumor diseases (C00-D48)
- Malignant neoplasm in the area of the bone.
Psyche – nervous system (F00-F99; G00-G99).
- Duchenne muscular dystrophy – genetic muscle wasting.
- Infantile cerebral palsy – neurological disorder whose causative damage to the central nervous system occurs before, during, or immediately after birth.
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)
- Pain, unspecified
- Growing pains – about one-third of all children between 2 and 12 years of age occasionally suffer from growing pains; they usually occur in the evening or at night (80% of cases); the next morning, the child can move without pain and without restrictions
- Symptoms/complaints:
- Localizations:
- Front sides of the thighs
- Backs of knees
- Shins or calves
- Pain always occurs on both sides, alternating between both extremities if necessary, and can vary in intensity
- Joints are not affected
- Growing pains are pain at rest, not pain on exertion [diagnosis of exclusion! Conditions to clarify include rheumatic diseases, bone tumors, bone infections or unnoticed bone injury]
- Complaints are self-limiting
- Warning signs (red flags) of malignancy (malignant tumor): B symptoms (severe night sweats, unexplained persistent or recurrent (recurrent) fever (> 38 °C); unwanted weight loss (> 10% percent of body weight within 6 months)), back pain as the main localization, palpable mass, bleeding tendency, nonarticular bone pain (bone pain that does not involve a joint); abnormalities in the blood count and smear, LDH ↑
- Physical examination: no abnormal examination results.
- Laboratory diagnostics:
- Small blood count
- Differential blood count
- ESR (erythrocyte sedimentation rate)
- If necessary, also determination of transaminases, alkaline phosphatase (AP), LDH, creatinine.
- Medical Device Diagnostics:
- X-ray in two planes
- Magnetic resonance imaging (MRI) of the affected region.
Injuries, poisonings and other consequences of external causes (S00-T98).
- Injuries (including foreign bodies in the foot, if applicable).
Further
- Leg length difference
- Foreign body, unspecified
