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The etiology of hip pain in pediatric and adolescent patients can be unclear. Osteoid osteoma (OO) about the hip in children has only been described in case reports or small studies. The present study assessed the clinical presentation and diagnostic course, imaging, and treatment approaches in a large cohort of pediatric cases of OO about the hip.Medical record and imaging results were reviewed for all cases of OO identified within or around the hip joint in patients20 years old between January 1, 2003, and December 31, 2015, at a tertiary-care pediatric center. Demographic, clinical, and radiographic data were analyzed.Fifty children and adolescents (52% female; mean age, 12.4 years; age range, 3 to 19 years) were identified. Night pain (90%) and symptom relief with nonsteroidal anti-inflammatory drugs (NSAIDs) (88%) were common clinical findings. Sclerosis/cortical thickening was visible in 58% of radiographs, although a radiolucent nidus was visible in only 42%. Diagnostic imaging findings included perilesional edema and a radiolucent nidus on 100% of available magnetic resonance imaging (MRI) and computed tomography (CT) scans, respectively. Initial alternative diagnoses were given in 23 cases (46%), the most common of which was femoroacetabular impingement (FAI). Delay in diagnosis of6 months occurred in 43% of patients. Three patients underwent operative procedures for other hip diagnoses, but all had persistent postoperative pain until the OO was treated. Of the 41 patients (82%) who ultimately underwent radiofrequency ablation (RFA), 38 (93%) achieved complete post-RFA symptom resolution.Initial misdiagnosis, the most common of which was FAI, and delayed correct diagnosis are common in pediatric OO about the hip. Presenting complaints were variable and nonspecific MRI findings were frequent. Night pain and relief with NSAIDs were present in the vast majority of cases. CT scans provided definitive diagnosis in all patients who received them. As increasing numbers of young, active patients are being evaluated for various causes of hip pain, such as FAI, OO should not be overlooked in the differential diagnosis.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Background: In this study, we sought to elucidate the presentation, clinical course, treatments pursued, final diagnosis, and risk factors for septic arthritis in a series of children with hip pain and intermediate synovial fluid values (white blood-cell [WBC] counts of 25,000 to 75,000 cells/mm3 [25 to 75 × 109 cells/L]). Methods: We reviewed the records of pediatric patients who underwent hip aspiration between 2005 and 2012 at a tertiary-care pediatric hospital. Demographic data, laboratory values, final diagnosis, and treatment details were recorded for the subpopulation of patients with an aspirate WBC count of 25,000 to 75,000 cells/mm3 (25 to 75 × 109 cells/L). Univariate and multivariable logistic regression analysis was used to assess risk factors for septic arthritis of the hip across final diagnostic groups and subgroups with WBC values of

Over the last decade, the diagnosis and arthroscopic management of labral tears of the hip in the young athletic population has evolved substantially due to improvements in clinical examination, diagnostic tools, surgical techniques, and flexible instrumentation in hip arthroscopy. Arthroscopic management of labral injuries in the hip has become an accepted therapeutic modality in appropriately selected patients. The treatment of labral tears and their associated disorders is crucial for hip preservation in young and active patients because several studies have demonstrated an association between labral tears and the early onset of osteoarthritis1-3. This paper will review the main causes of labral tears in the hip, including labral tears secondary to trauma, femoroacetabular impingement, instability, psoas impingement, dysplasia, and degenerative arthritis. We will discuss relevant anatomy and history, typical findings on physical examination, types of imaging studies performed, and treatment options, with a focus on the arthroscopic management of labral injuries, including labral repair. The outcomes associated with open surgical dislocation as compared with arthroscopic treatment of femoroacetabular impingement will also be reviewed. The acetabular labrum is a fibrocartilaginous structure that is located circumferentially around the acetabular perimeter and becomes attached to the transverse acetabular ligament posteriorly and anteriorly. Neuroreceptors have been identified within the labrum, and these structures may provide proprioception to the hip joint4. The articular surface of the labrum has decreased vascularity and a limited synovial covering in comparison with the portion of the labrum at the peripheral capsulolabral junction5 (Figs. 1-A and 1-B). Thus, similar to the healing potential of the menisci in the knee, which is greatest at the periphery, the healing potential of the labrum is greatest at the peripheral capsulolabral junction5-8. The labrum has an important sealing function in the hip. It plays …