A 6-year-old boy has 4 months of intermittent limping of the left leg, worse with activity. Examination shows limited internal rotation and abduction of the left hip with mild thigh muscle wasting. Radiographs show fragmentation and flattening of the left femoral head epiphysis. What is the most likely diagnosis?

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

Explanation

Legg-Calve-Perthes is idiopathic avascular necrosis of the capital femoral epiphysis, typically affecting boys aged 4 to 10 years, producing insidious limp, restricted abduction and internal rotation, and radiographic epiphyseal fragmentation. Slipped capital femoral epiphysis occurs in overweight adolescents around puberty with the physis displaced inferiorly and posteriorly, not fragmented.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.