A 7-Year-Old Boy Is Brought to the Office for Evaluation

A 7-year-old boy is brought to the office for evaluation of chronic left thigh pain and a limp.  The pain began 8 months ago as an intermittent ache, especially after soccer practice.  The patient's family thought his symptoms were growing pains and have been giving him ibuprofen as needed for pain, with some improvement.  Over the past month, however, the pain has been constant, and the patient recently developed a limp.  He has had no fever, additional joint pain, or chronic medical problems and takes no daily medications.  While walking to the examination table, the patient avoids bearing full weight on the left leg.  Examination shows significantly limited range of motion of the left hip and atrophy of the left proximal thigh muscle.  The remainder of the examination is unremarkable.  X-ray of the pelvis is shown in the image. Which of the following is most likely responsible for this patient's condition?

A) Bone infection
B) Malignancy
C) Muscular dystrophy
D) Osteonecrosis
E) Slipped epiphysis
F) Stress fracture
G) Synovitis

Correct Answer:

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