QuestionSBA
QuestionChoice
This is unlikely because it is the most common hip disorder in adolescents and does not typically affect children. It would also have different X-ray findings: short displaced epiphysis and widened growth
plate.
10003653
c
Slipped upper femoral epiphysis
QuestionChoice
Perthes disease is common in boys aged 4-8 and tends to persist for > 4 weeks which is consistent with the child in this question. The diagnosis of Perthes disease is supported by the X-ray findings of sclerosis and fragmentation of the epiphysis, which are characteristic of this disease.
10003651
a
Perthes disease
QuestionChoice
The patient does experience pain, but there are no other signs or symptoms of osteomyelitis such as fever, erythema or swelling. The patient also does not have any risk factors for osteomyelitis as they are generally well.
10003655
e
Osteomyelitis
QuestionChoice
This is also a cause of a limp in children and commonly affects children aged 3-11. However, this is generally preceded by a viral infection 1-2 weeks before the development of pain and the limp. The pain and limp do not typically last for longer than 2 weeks.
10003652
b
Transient synovitis
QuestionChoice
This is unlikely because whilst the patient has groin pain, there is no mention of joint swelling. The patient also experiences no other systemic symptoms and is otherwise well.
10003654
d
Juvenile idiopathic arthritis
Concept
Chapter
2693
3769
Perthes disease
Topic
145
Orthopaedics
13277
A 6-year-old boy presents to his GP with a gradual onset limp and intermittent groin pain whilst climbing the stairs. The pain has persisted for 5 weeks now. On examination, there is reduced movement of the hip joint. The patient is otherwise well.

An X-ray shows sclerosis and fragmentation of the epiphysis.

What is the most likely diagnosis?
a