Differential Diagnosis for 15-year-old Male with Left Hip and Groin Pain
Single Most Likely Diagnosis
- Slipped Capital Femoral Epiphysis (SCFE): This condition is the most likely diagnosis given the patient's age, weight percentile, and symptoms. SCFE is a common cause of hip pain in adolescents, especially in those who are overweight. The external rotation of the left hip and shortening of the left lower extremity are classic signs of SCFE.
Other Likely Diagnoses
- Femoroacetabular Impingement (FAI): FAI is a possible cause of hip pain in adolescents, especially those who are active in sports. The patient's symptoms of hip and groin pain could be consistent with FAI.
- Perthes Disease: This condition is a possible cause of hip pain in children and adolescents, characterized by avascular necrosis of the femoral head. The patient's age and symptoms could be consistent with Perthes disease.
- Apophysitis (e.g., iliac apophysitis): Apophysitis is an inflammation of the growth plates and can cause hip and groin pain in adolescents. The patient's symptoms could be consistent with apophysitis.
Do Not Miss Diagnoses
- Septic Arthritis: Although less likely, septic arthritis is a serious condition that requires prompt diagnosis and treatment. The patient's symptoms of hip pain and limited mobility could be consistent with septic arthritis.
- Osteosarcoma or other bone tumors: Although rare, bone tumors such as osteosarcoma can cause hip pain and should not be missed. The patient's symptoms of persistent pain and limited mobility could be consistent with a bone tumor.
- Inflammatory conditions (e.g., juvenile idiopathic arthritis): Inflammatory conditions such as juvenile idiopathic arthritis can cause hip pain and should not be missed. The patient's symptoms could be consistent with an inflammatory condition.
Rare Diagnoses
- Legg-Calve-Perthes disease variant (e.g., multiple epiphyseal dysplasia): These conditions are rare and can cause hip pain in children and adolescents.
- Gaucher disease: This is a rare genetic disorder that can cause hip pain and other skeletal abnormalities.
- Sickle cell disease with avascular necrosis: Although rare, sickle cell disease can cause avascular necrosis of the femoral head, leading to hip pain.