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Question
A 13-year-old boy presents with left knee pain of one month's duration. His mother says that she has noticed him limping for the past three days. The pain is described as dull and aching. He denies any history of trauma or paresthesia. The pain is exacerbated with exertion and relieved by rest. The pain does not awaken the patient at night, nor does it radiate. On physical examination, his BP is 100/70, HR 105, height is at the 50th percentile for age, and the weight greater than 90th percentile for age. The knee does not appear red, warm, or swollen and has no obvious deformities. While supine, his left leg is slightly externally rotated at rest as compared to the right. He has no tenderness to palpation of the left knee. Passive motion is limited by intense pain. On gait, he limps to avoid bearing weight on the left leg with downward pelvic tilt toward the right when he steps on his left leg.
1. What is the most likely diagnosis?
2. What are complications that can occur due to this condition?
3. What is the best management for this condition?
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