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Pelvis Case #3

Post on 01-Jun-2015




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  • 1. 7 yo boy presents to the er complaining of several weeks of left hips and knee pain. Mom brings him in today because she notes that he has been limping. They deny history of trauma. No fevers, weight changes, or other complaints. PE Afebrile. VSS Gen: Well appearing, non-toxic. Short stature. Extrem: Decrease ROM left hip. Esp w/ internal rotation and abduction

2. Consider differential diagnosis Sickle cell disease, septic hip, trauma Consider CBC and ESR. B/L hip films and frog leg views can be helpful NSAIDs are the mainstay for treatment of pain control Orthopedic follow-up 3. Caused by interruption of blood flow to the capital femoral epiphysis. Bone infarction occurs and subchondral fractures occur Most common in males. Patients that present at a younger age typically have a better outcome 15-20% of patients have bilateral problems but they are typically at different stages 4. Nochimson, G et al. Legg-Calve-Perthes Disease in Emergency Medicine. Emedicine.com. 4/2011. Tininalli, J et al. Emergency Medicine: A Comprehensive Study Guide. 6th ed. 2003 Wheeless, C. Legg-Calve-Perthes Disease. Wheelessonline.com. 4/2011.