Which condition is most likely in an overweight adolescent presenting with hip pain and limited hip flexion?

Which condition is most likely in an overweight adolescent presenting with hip pain and limited hip flexion?

• A. Slipped Capital Femoral Epiphysis
• B. Avascular Necrosis
• C. Legg-Calvé-Perthes Disease
• D. Subcapital Femoral Fracture

Answer: (A)

In an overweight adolescent with hip pain and limited hip flexion, slipped capital femoral epiphysis is the most likely diagnosis. This condition occurs when the femoral head slips gradually or suddenly through the growth plate during a period of rapid growth, with obesity being a major risk factor. The hip exam characteristically shows reduced internal rotation and flexion, and the leg may sit in an externally rotated position. Pain can even be referred to the knee, which can delay recognition. Prompt identification is crucial because delaying treatment increases the risk of worsening displacement and avascular necrosis of the femoral head, so urgent stabilization with surgical pinning is typically needed. Avascular necrosis tends to be related to other risk factors and ages, Legg-Calvé-Perthes disease occurs in younger children with a more gradual onset, and a subcapital femoral fracture follows significant trauma with acute deformity and inability to bear weight.

In an overweight adolescent with hip pain and limited hip flexion, slipped capital femoral epiphysis is the most likely diagnosis. This condition occurs when the femoral head slips gradually or suddenly through the growth plate during a period of rapid growth, with obesity being a major risk factor. The hip exam characteristically shows reduced internal rotation and flexion, and the leg may sit in an externally rotated position. Pain can even be referred to the knee, which can delay recognition. Prompt identification is crucial because delaying treatment increases the risk of worsening displacement and avascular necrosis of the femoral head, so urgent stabilization with surgical pinning is typically needed. Avascular necrosis tends to be related to other risk factors and ages, Legg-Calvé-Perthes disease occurs in younger children with a more gradual onset, and a subcapital femoral fracture follows significant trauma with acute deformity and inability to bear weight.