A 12-Year-Old Boy Is Brought to the Office for Evaluation

A 12-year-old boy is brought to the office for evaluation of a limp.  Since waking this morning, the patient has not been able to put any weight on his right leg due to hip pain.  He has had this pain for the past 2 days and has been taking ibuprofen, but the pain has not improved.  The patient plays in a baseball league and practices a few days a week.  Last week, he fell during practice and scraped his right hip.  The abraded area developed mild cellulitis, which was treated with topical antibiotic ointment.  The patient has no chronic medical conditions or previous surgeries.  Temperature is 38.9 C (102 F) .  Height is at the 30th percentile and weight is at the 70th percentile for age.  On examination, the right hip is externally rotated and has pain with passive movement.  The remainder of the examination is normal.  Hemoglobin is 13 g/dL, platelets are 280,000/mm³, and leukocyte count is 18,000/mm³.  Erythrocyte sedimentation rate is 52 mm/hr.  Which of the following treatment options would be most beneficial in preventing long-term morbidity for this patient's condition?

A) Cast immobilization
B) Intraarticular corticosteroid injection
C) Joint aspiration and drainage
D) Surgical pinning of the joint
E) Total hip arthroplasty

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free