Hip pain in a 15-year-old boy
Pediatric Emergency DepartmentMateo Alvarez · 15yo male · CC: Right hip and knee pain
History
0/6 key findingsAsk the questions your differential demands — not just the ones the case volunteers. Every diagnosis you intend to list owes you one discriminating question.
CASE SETTING: PEDIATRIC EMERGENCY DEPARTMENT
Mateo Alvarez, a 15-year-old boy with right hip and knee pain and an externally rotated limp
Vitals
Opening
Mateo Alvarez, a 15-year-old boy, is brought to the Pediatric Emergency Department by his father, Carlos, for worsening right thigh and knee pain and a limp that became acute after stepping off a school bus 3 hours ago. Mateo is sitting upright on the stretcher with his right lower extremity resting turned outward. His father is standing beside the bed ready to answer questions.
Triage note
15-year-old male with 3 weeks of intermittent right anterior thigh and medial knee ache that acutely worsened 3 hours ago stepping off the school bus. BMI 31.2 kg/m² (97th percentile). Afebrile.
From the patient
"At first I thought I tweaked my right knee in gym class a few weeks ago, but when I stepped off the bus today my right hip and knee caught sharply and now my foot wants to point outward when I limp."
Mateo Alvarez · 15yo male
Sitting on the stretcher holding his right leg in external rotation, wincing when shifting his weight