All the following are causes of a painful limb EXCEPT (AIIMS Nov 2010)
|A||Slipped femoral epiphysis|
|B||TB of the hip|
|D||Congenital coxa vara|
Congenital coxa vara
a. Slipped femoral epiphysis - upper femoral epiphysis may get displaced at the growth plate usually postero-medially resulting in coxa-vara presents with age between 12-14 years pain in the grain often radiating to the thigh and knee is the common presenting symptoms.
b. Congenital coxa-vara - reduce angle between neck and shaft of the femur
c. It is noticed as a painless limpless in a child who has just started walking.
d. On examination the abduction and internal rotation of he hip are limited and the leg is short.
e. Treatment - subtrochanteric corrective osteotomy
f. Perthe's disease - (Coxa-plana, pseudocoxalgiA. This is on osteochondritis of the epiphysis of the femoral head.
g. Common in boys in the age group of 5-10 years. The child, presents with a pain in the hip, often radiating to the knee.
a. Gait, lameness is one of the first signs
b. Limp is exaggerated by pain so that the child has tens to take the weight off the affected, this is called the "painful or antalgic gait"