Paediatrics – hip

What is it?

Snapping hip syndrome is a commonly seen condition in children and adolescence and in most cases can be treated with basic care and exercises. It is an umbrella term for a variety of causes of hip pain and/or clicking. It can be associated with a feeling of the hip snapping or popping out of place.

Would an X-ray help?

Following an assessment an x-ray may be recommended to rule out other hip conditions dependent on symptoms and age but for snapping hip syndrome an x-ray is not required to make the diagnosis and begin treatment.

X-rays work by passing a low level radiation through the body to produce an image. Due to the radiation x-rays will only be used if there is no other way to accurately diagnose the problem or if there is a concern that there may be a more serious problem. Radiologists (people who complete the x-rays) will only do one if they feel the referring clinician (such as a doctor, specialist physio or nurse practitioner) has given a valid reason for the risk of radiation. This means that you may have been referred for an x-ray but it has not been completed because the radiologists feel that other methods should be used to determine the problem first.

For more information about X-rays please see the NHS website below:

What are the options at East Sussex Healthcare NHS Trust (ESHT)?

1. Physiotherapy – If you have hip pain, this is normally the first port of call. Options include advice, exercises, hands on therapy, acupuncture, hydrotherapy or gym-based rehabilitation.
2. Advanced Practitioner – If your hip pain has not improved with Physiotherapy, a referral to the AP may be your next option. Here you can discuss current management options, including the merits of medical imagining.
3. Orthopaedics – If the AP is concerned or imagining is completed and shows something abnormal an appointment with an orthopaedic consultant maybe advised. Further management and treatments can be discussed here; including surgical intervention if indicated (although this is rare in children and would need to be completed at a specialised centre).
4. Pain Management Programme – Although not provided by ESHT. A referral into the Evelina Hospital in London’s Pain management programme may help for pain that is not resolving or does not have a specific medical cause.

What is it?

SCFE (slipped capital femoral epiphysis) or SUFE (slipped upper femoral epiphysis) is one of the most common hip disorders affecting adolescents. It is more common in boys than girls and is more prevalent in obese children. The typical age on onset is 11 to 12 in girls and 12 to 13 in boys and it is often associated with a growth spurt. SCFE is a fracture to the growth plate of the thigh bone that results in the ball at the end slightly slipping off the rest of the bone. It requires surgical repair with a long screw to allow it to properly heal and the outcomes of this are very good.

Would an x-ray help?

In the case of SCFE/SUFE an X-ray is required to determine the severity of the slip and this will allow for the medical team to determine the best course of treatment. The treatment will be decided on by on Orthopaedic Consultant. Normally surgery is required to correct the slip.

X-rays work by passing a low level radiation through the body to produce an image.

For more information about x-rays please see the NHS website below:

What are the options at East Sussex Healthcare NHS Trust (ESHT)?

You will either see a specialist physiotherapist or advanced practice physiotherapist who will assess you and request an x-ray if there are concerns of SCFE/SUFE following assessment. Based on the results of the x-ray you will either continue with physiotherapy or be referred to the Paediatric Orthopaedic team for further management.

Additional information