Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of right hip/knee pain and an antalgic gait. Onset is insidious, with progressive discomfort over [Number] weeks/months. Denies recent trauma. Pain is exacerbated by activity and relieved by rest. Associated symptoms include limited internal rotation of the right hip and occasional referred pain to the distal thigh or knee.
Clinical Examination Findings
Physical examination reveals an antalgic gait favoring the right lower extremity. Right hip range of motion demonstrates limited internal rotation, abduction, and flexion. Obligatory external rotation is noted during passive hip flexion (Drehmann sign positive). No signs of erythema, warmth, or local swelling. Neurovascular status of the right lower extremity is intact distally.
Treatment Protocol
Immediate non-weight bearing status for the right lower extremity is mandatory. Referral to Pediatric Orthopedic Surgery for urgent stabilization (in-situ pinning). Pain management with NSAIDs as directed. Monitoring for potential complications including avascular necrosis (AVN) and chondrolysis.