The Limping Adolescent - Page #1

Author: Nathan Fitton, DO
Senior Editor: Margaret Gibson, MD, FAMSSM
Editor: Warren Bodine, DO, FAMSSM

Patient Presentation:
A 12 year-old male presented during football season with right hip pain.

A 12 year-old male presented to sports medicine with right hip pain in November of 2018. It was inconsistent with its timing over the last year but progressed recently unprovoked. He denied any inciting event or trauma. The pain is deep in the right hip and described as an ache. The pain was worse with prolonged standing, sitting, and walking. There was no radiation of the pain. He denied fevers, night sweats, weight loss, fatigue.

Physical Exam:
Gen: Alert and oriented x 3
Pulm: non labored, no distress
Psych: insight WNL, mood WNL, memory intact
Non-tender over greater trochanter, ASIS, iliac crest, sacral base and ILA
B/L pes planus, genu valgum
ROM: equal and symmetric hip extension (30 degrees) and flexion (110) along with internal and external rotation
4-/5 B/L hip abduction, otherwise 5/5
Scour Test: -
Modified Thomas Test: +
Standing flexion: + L
Left anterior innominate with long leg
Stork: + L
R on L sacral torsion
Myofascial restrictions lumbar paraspinals, iliopsoas

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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