Musculoskeletal: what’s different in children? Fell down the stairs two times; now limping

Excerpt

This 5-year-old male was staying at his aunt's place and ran down stairs to play basketball with his friends. He tripped and fell down the last two stairs. After that he got up and seemed unharmed. He went on to play basketball with no complaints. When his turn to play was over he returned to the house and went upstairs. However, he was shortly called back to play again and then ran down the stairs and tripped again, this time over the last four stairs. Again he got up with no complaints and played basketball. Later that afternoon his mother picked him up and took him home in her car. When he got out of the vehicle he complained of some right hip pain. The mother gave him an analgesic and rubbed the area with alcohol. He then went to bed for a nap but woke up about 4 hours later and while walking to the bathroom began to limp and again complain of right hip pain. It was at this point that his mother decided to bring him to our Emergency Room (ER). On arrival to the ER he did not appear to be in any acute distress. All his systems were normal and actually he had normal range of movement of his extremities including the right leg. However when he moved it, he said it did hurt. Because of this, radiographs of this pelvis and hips were obtained (Fig. 1).

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