Pediatrics Case 12 History/Physical

Presentation often has an insidious course, and patients presents with a limp. If there is associated pain, patients will tend to have groin pain or referred pain to the thigh and knee. Pain will worsen with activity and improve with rest. In advanced cases, patients can present with a Trendelenburg gait, which is associated with muscle atrophy, and a shortened leg.

On exam, pain is reproduced with hip internal rotation and abduction and there may be a visible leg-length discrepancy in advanced cases.