Differential Diagnosis for Hip Pain in Adolescence after Growth Spurt with Normal Body Weight

Single Most Likely Diagnosis

• Slipped Capital Femoral Epiphysis (SCFE): This condition is common in adolescents, especially during growth spurts, and is characterized by the displacement of the femoral head from the femoral neck through the physeal plate. It is more common in obese adolescents but can also occur in those with normal body weight.

Other Likely Diagnoses

• Transient Synovitis: An inflammatory condition of the hip joint that can cause pain and stiffness, often following a viral infection. It's more common in children but can occur in adolescents.
• Apophysitis (e.g., iliotibial band syndrome, greater trochanteric pain syndrome): Inflammation of the apophysis, which is a bony projection where muscles or ligaments attach. This can be painful, especially after a growth spurt.
• Stress Fractures: Overuse injuries that can occur in the hip or femur, especially in adolescents who participate in sports or have recently increased their physical activity.

Do Not Miss Diagnoses

• Septic Arthritis: A bacterial infection within the joint space that requires immediate medical attention to prevent long-term damage. It's less common but critical to diagnose early.
• Osteonecrosis (Avascular Necrosis): The death of bone tissue due to a lack of blood supply, which can be caused by various factors, including trauma, steroids, or sickle cell disease. Early diagnosis is crucial for effective management.
• Bone Tumors (e.g., osteosarcoma, Ewing's sarcoma): Although rare, these conditions can present with hip pain and are critical to diagnose promptly due to their potential for malignancy.

Rare Diagnoses

• Legg-Calve-Perthes Disease: A rare condition characterized by the temporary loss of blood supply to the hip joint, leading to necrosis of the bone. It typically affects children between the ages of 4 and 10 but can occasionally be seen in early adolescence.
• Sickle Cell Disease with Hip Crisis: For adolescents with sickle cell disease, a hip crisis can occur due to vaso-occlusive episodes affecting the femoral head, leading to severe pain.
• Gaucher's Disease: A genetic disorder that can lead to bone infarcts and pain, including in the hip area, though it's very rare and usually associated with other systemic symptoms.