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Cause of Groin Pain Is Frequently Hard to Determine in Children

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WebMD Health News

Nov. 15, 1999 (Tuscaloosa, Ala.) -- Parents should never ignore their child's complaint of knee or groin pain because pain in either area can be a symptom of a potentially deforming hip injury, two leading orthopedic experts tell WebMD.

"Groin pain is a frequent complaint of adolescents, but the cause is often difficult to diagnose because the many different parts of the hip can produce similar types of pain," says John W. O'Kane, MD, the team physician for the University of Washington (UW) Huskies football team in Seattle.

Conditions ranging from a benign muscle pull or tendon strain to a "potentially catastrophic" stress fracture of the neck of the femur [thighbone] can cause similar types of pain," O'Kane tells WebMD. O'Kane reviews symptoms of and treatment for adolescent hip pain in the cover article of the Oct. 15 issue of American Family Physician.

Groin pain can be a signal of the "potentially catastrophic" stress fracture known as a "slipped capital femoral epiphysis," simply nicknamed 'slip,' according to O'Kane, an assistant professor of orthopedics at UW's School of Medicine.

"A 'slip' is a very, very treacherous injury," agrees James T. Bennett, MD, a specialist in pediatric orthopedics at Tulane University, New Orleans. "When we talk about adolescents with hip pain, the number one, number two, and number three thing that examining doctors should think about is this slippage of the growth plate."

"Delayed treatment can result in deformity," he warns. "Being slow to act on a child's complaint of groin pain has been the source of guilty feelings for many parents who didn't bring the child in for treatment as promptly as they would have if they had known the potential seriousness of the symptom."

Typical patients are "overweight male adolescents who are in a period of rapid growth," says O'Kane. "Symptoms can include hip or knee pain or a limp."

When a 'slip' is suspected, the patient should avoid putting any weight on the affected hip and should have X-rays. If the suspicion is confirmed, "the patient should be referred immediately to an orthopedist for surgery," O'Kane advises. The child's other hip also should be checked by a physician because " injury [in both hips] is present in as many as 40% of all patients," he adds.

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