What is the most likely underlying mechanism of a painless right-sided limp and limited left hip abduction in a 16-month-old girl with a shorter left lower extremity and normal sensation, circulation, and muscle strength?

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Differential Diagnosis

  • Single most likely diagnosis
    • F) Poorly developed acetabulum: This is the most likely diagnosis, given the patient's presentation of a painless limp, limited abduction of the left hip, and a shorter left lower extremity. These findings are consistent with developmental dysplasia of the hip (DDH), which is often associated with a poorly developed acetabulum.
  • Other Likely diagnoses
    • D) Displacement of the capital femoral epiphysis: This condition, also known as slipped capital femoral epiphysis (SCFE), can cause a limp and limited hip mobility. However, it typically presents with pain and is more common in older children and adolescents.
  • Do Not Miss
    • B) Acute suppurative arthritis: Although less likely, given the patient's painless presentation, acute suppurative arthritis is a serious condition that requires prompt diagnosis and treatment to prevent long-term joint damage.
  • Rare diagnoses
    • A) Acute epiphyseal fracture: This is an unlikely diagnosis, given the patient's age and presentation, but it is a possible cause of a limp and limited mobility.
    • C) Avulsion of muscle origin: This is also an unlikely diagnosis, as it typically presents with pain and is more common in older children and adolescents.
    • E) Failure of osteoid to mineralize: This condition, also known as rickets, can cause bone deformities and weakness, but it is less likely given the patient's presentation and lack of other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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