If it is very red and swollen, it may be infected and should be evaluated by a physician immediately. If the toe on one side looks bigger than the one on the other but the child is not complaining, squeeze it gently. Often the toe is tender and the child will pull the foot away. If that happens, gently take the foot in your hand and squeeze just behind where the toe attaches to the foot. If that is also tender, it suggests arthritis. Pain due to bleeding under the toenail, known as tennis toe, is most commonly an injury in older children but may occur in younger children whose shoes are too small.
The chronic slippage should be evident on X-ray. In uncertain or difﬁcult cases, an MRI may be useful to conﬁrm the diagnosis. Orthopedists treat SCFE by putting a pin in the bone to hold the epiphysis in place while the bone heals. If detected and treated early, children with SCFE usually do well. Chronic SCFE that is not promptly treated may result in damage Common causes of pain | 25 to the head of the hip bone (femur). This can result in a permanent limp, difference in the length of the two legs, and early onset of arthritis due to mechanical damage.
There is also concern that children with residual damage from LCP may have persistent mechanical problems that will cause them to have mechanical arthritis of the hip, leading to problems when they become adults. Sickle-cell anemia may cause pain in the bones because of blood vessels being blocked by abnormally shaped red blood cells. This may occur in the blood vessels that supply the hip and result in damage to the femur. When it does, it looks exactly like—and essentially is—LCP. In children with severe sickle-cell anemia, other bones may be damaged also and there may be widespread joint problems.
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