A 13-Year-Old Boy Is Seen in the Office for Persistent

A 13-year-old boy is seen in the office for persistent right knee pain.  He first noticed a dull pain along the anterior knee 2 months ago.  Initially, the pain was noticeable only after basketball practice.  Two days ago, the pain worsened after the patient landed during a rebound attempt at a basketball game.  The knee pain is now constant and not relieved with ibuprofen or ice.  The patient has no chronic medical conditions.  Temperature is 37.4 C (99.3 F) .  Height is at the 75th percentile, and weight is at the 95th percentile.  The patient walks with a limp with the right foot pointed laterally.  There is no tenderness, erythema, or swelling around the right knee.  The anterior and posterior drawer tests are normal.  No abnormal findings during knee flexion and extension are present with either internal or external rotation of the tibia.  Range of motion of the right hip is limited, and the knee points laterally upon passive hip flexion.  Which of the following is the most likely diagnosis in this patient?

A) Anterior cruciate ligament tear
B) Medial meniscus tear
C) Osgood-Schlatter disease
D) Osteoarthritis of the hip
E) Osteoid osteoma of the proximal femur
F) Slipped capital femoral epiphysis
G) Transient synovitis of the hip

Correct Answer:

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