26th August 2020

A 4-year-old boy presents to his GP

A 4-year-old boy presents with his mother to his GP. Over the last 2 days he has been limping. His mum says he refuses to climb stairs or walk any distances because it causes him pain. He is otherwise fit and well and he is developing normally. His weight is stable and normal for his age. Mum tells you that he loves trains and was ‘a bit snuffly’ a couple of weeks ago for which he had to have two days off school. On examination, he looks well but refuses to weight bear and complains of pain in hip extension, abduction and internal rotation. He has a mild fever of 37.8 degrees. The rest of the examination is normal.

Which of the following is the most likely cause of this child’s hip pain?

Select the SINGLE most appropriate option from the list below. Select ONE option only.