Module 29, General Medical Level

This is a 12 year old Asian female with an insidious onset of left hip pain lasting 4 months. At one point, her pain was so severe she could not bear weight. She denies trauma to the hip. She could not participate in sports secondary to the pain and developed a limp.

Question 29A

Slipped capital femoral epiphysis (SCFE) has to be considered but the onset usually is more acute.

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Question 29B

A physical examination and an x-ray are the first evaluations which should be required.

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Question 29C

An MRI is the most useful secondary imaging tool to evaluate this painful hip.

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Question 29D

Laboratory tests should be ordered and will likely yield a specific diagnosis.

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Question 29E

If the imaging studies and blood work are normal the next invasive test should include a hip joint arthroscopy.

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