Cause of Groin Pain Is Frequently Hard to Determine in Children
WebMD News Archive
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
"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
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
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.
"Special consideration must be given by doctors to the fact that the
skeletons of young people are still growing," says O'Kane. The growing
portions are weaker than surrounding bone or tendon and "therefore
susceptible to acute and chronic injuries."
Those growing areas, spongy patches of cartilage located at each end of
bones such as the femur, are known as 'growth plates.' They can be likened to
the mobile blocks or plates that make up the crust of the earth.