Pediatrics Case 11 History/Physical

Patients often complain of a subacute course of hip, thigh, or knee pain without a traumatic event. In stable SCFE, ambulation is still possible and generally follows this more indolent course. There is typically intermittent hip and groin pain, especially after activity, and weakness or soreness of the affected limb. As the slip worsens, patients have increasing difficulty with movement, especially internal rotation and flexion of the hip. Leg length discrepancy can become apparent in more severe instances.

Less commonly, SCFE can present unstably in a patient with too much pain to ambulate. Patients complain of sudden onset acute pain, often after a fall or injury. The patient’s affected hip will be held in flexion and will be externally rotated.