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
Cevap
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.
Adım Adım Çözüm
Anahtar Kavram
Differentiating pediatric lower extremity pathologies based on patient age, body habitus, acuity of onset, and classic physical examination findings.
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