A pediatric orthopedic clinic evaluates several patients with lower extremity complaints. Match each patient's clinical presentation with the most likely underlying diagnosis.
- A 13-year-old boy with a BMI of 33 kg/m² presents with several weeks of left knee pain and a limp. Passive flexion of the left hip results in obligatory external rotation.Slipped capital femoral epiphysis
- A 6-year-old boy is evaluated for a limp that has worsened over the past three months. He has limited abduction and internal rotation of the right hip. Radiographs show fragmentation of the femoral head.Legg-Calvé-Perthes disease
- A 4-year-old boy develops acute-onset right hip pain and refuses to bear weight 1 week after a viral upper respiratory infection. Vital signs and inflammatory markers are within normal limits.Transient synovitis of the hip
- A 14-year-old male basketball player presents with anterior knee pain exacerbated by jumping. Examination shows a prominent and tender tibial tubercle.Osgood-Schlatter disease
Answer
The 13-year-old obese boy matches with Slipped capital femoral epiphysis; the 6-year-old with femoral head fragmentation matches with Legg-Calvé-Perthes disease; the 4-year-old post-viral patient matches with Transient synovitis of the hip; and the 14-year-old basketball player matches with Osgood-Schlatter disease.
Each clinical presentation contains classic demographic and physical exam hallmarks that uniquely identify the underlying pediatric orthopedic condition without overlapping features. SCFE presents with obligatory external rotation; Legg-Calvé-Perthes with avascular necrosis in younger boys; transient synovitis with acute post-viral pain and normal labs; and Osgood-Schlatter with tibial tubercle tenderness in jumping athletes.
Step-by-Step Solution
Key Concept
Differentiating pediatric lower extremity pathologies based on patient age, body habitus, acuity of onset, and classic physical examination findings.
Estimated Time:1m 30s