Left sided hip pain

Differential Diagnosis

• Toxic synovitis
• Septic arthritis
• Osteomyelitis
• Fracture
• Non-accidental trauma

Patient Workup History

• Mother states patient was normal when she put her in her crib for a nap, but was unable to bear weight on her left leg when she woke up.
• Normally, patient is standing in her crib when she wakes up from her nap, but today mother found her sitting in her crib.
• Mother states patient started crying when she tried to walk with assistance.
• No recent trauma. Patient is being treated for an ear infection but is otherwise very healthy.
• Patient is normally very active and runs around playing with her older brother.
• Patient has been walking for ~6 months

Physical Exam

• Pain when straightening leg
• Normal neurological reflex
• No swelling and non-tender to palpation.
• X-ray by ED found increased fluid in left hip joint.
• GSC – 15