A 13-year-old obese boy reports left groin and medial knee pain for 3 weeks. He walks with an antalgic limp, and the affected limb lies in external rotation with limited internal rotation on examination. The most likely diagnosis is:

• A Osgood-Schlatter disease
• B Transient synovitis of the hip
• C Legg-Calve-Perthes disease
• D Slipped capital femoral epiphysis ✓

Explanation

The combination of early adolescent age, obesity, groin or thigh or referred knee pain, antalgic limp, and obligatory external rotation with restricted internal rotation is classic for slipped capital femoral epiphysis. Perthes occurs in younger children (5 to 10 years) without obesity predominance, and transient synovitis follows a viral prodrome and resolves quickly. Osgood-Schlatter causes localized tibial tubercle pain with kneeling discomfort, not hip rotation limitation.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.