My sister runs her kids to the doctor for every little thing. Now all of a sudden, her son (my 10-year-old nephew) is complaining of severe hip pain and she’s ignoring it. Could this be something serious?

Pain is not always a helpful predictor of a serious problem. Constant, intense pain certainly gets our attention. Pain or discomfort in growing, active children is often labeled and dismissed as growing pains. But hip pain in children can be caused by infection, tumor, or fracture.

Other conditions such as Perthes disease or Slipped Capital Femoral Epiphysis (SCFE) are also possible causes of hip pain in children. Perthes is a condition that affects the hip in children between the ages of four and eight. The condition is also referred to as Legg-Calve-Perthes disease in honor of the three physicians who each separately described the disease.

In Perthes disease, the blood supply to the growth center of the hip (the capital femoral epiphysis) is disturbed, causing the bone in this area to die. The blood supply eventually returns, and the bone heals. How the bone heals determines how much problem the condition will cause in later life. This condition can lead to serious problems in the hip joint later in life.

SCFE is is a condition that affects the hip in teenagers between the ages of 12 and 16 most often. Cases have been reported as early as age nine years old. In this condition, the growth center of the hip (the capital femoral epiphysis) actually slips backwards on the top of the femur (the thighbone). If untreated this can lead to serious problems in the hip joint later in life. Fortunately, the condition can be treated and the complications avoided or reduced if recognized early. Surgery is usually necessary to stabilize the hip and prevent the situation from getting worse.

Either of these conditions can cause sudden and severe hip pain. The child may not be able to put weight on that leg. Early diagnosis and treatment is important for both of these conditions. Preventing complications and an unstable hip early on can help prevent serious complications later.

If there is no improvement in the child’s symptoms within a day or two, it may be helpful to suggest a visit to the doctor. Your support and interest may be what your sister needs in this situation.