A 2 year old 70 kg child presents with limitation of abduction and internal rotation. On examination there is tenderness in scarpa's triangle. On flexing the hip the limb is abducted. What is the MOST likely diagnosis?
This condition tend to occur in adolescent obese children, and is thought to be due to hormonal predisposition. Patients usually presents with either acute or chronic hip or knee pain with an associated limp. An adolescent complaining of knee pain, paicularly if overweight has Slipped capital femoral epiphysis until proven otherwise. On examination there is restricted internal rotation of the hip and limited abduction. AP and frog leg lateral views of hips are useful in diagnosis. In the AP view, Klein's line drawn along the femoral neck shows the relative varus of the femoral epiphysis and a similar line drawn on the lateral view demonstrates the relative posterior displacement. Ref: Textbook of Clinical Pediatrics page 3935. Pediatric Ohopedics in Practice By Reinald Brunner page 218
Pehes disease
Slipped capital femoral epiphyses
Observation hip
Tuberculosis hip