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Slipped capital femoral epiphysis
1%
33/3942
Legg-Calve-Perthes disease
7%
268/3942
Developmental dysplasia of the hip
6%
250/3942
Residual effects of previous untreated septic hip arthritis
85%
3358/3942
Acute femur fracture secondary to child abuse
0%
7/3942
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This child is presenting with radiographic and clinical findings consistent with the sequelae of untreated septic hip arthritis. Specifically, the child is limping and there is complete destruction of the femoral head/neck in the pelvic radiograph. Furthermore, the radiograph is not consistent with any of the remaining choices. Dobbs et al. review a case series of 5 patients with previous untreated septic arthritis, treated with proximal femoral osteotomy. The authors found all 5 patients had stable, painless, and functional hips. Vitale and Skaggs review the diagnosis, treatment, and outcome of young patients (6 months to 4 years) with developmental dysplasia of the hip. Incorrect answers: 1) Slipped capital femoral epiphysis - radiographs would show the epiphysis displaced upon the femoral neck (Illustration A) and typically occurs in an older age group 2) Legg-Calve-Perthes disease - radiographs would show the epiphysis undergoing some stage of resorption or reossification (Illustration B) 3) Developmental dysplasia of the hip - radiographs would show the femoral head incompletely covered by a dysplastic acetabulum (Illustration C) 5) Femur fracture - radiographs would show a fracture (Illustration D)
3.1
(24)
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