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Case Study: Slipped Capital Femoral Epiphysis (SCFE) Case Study: Joanne is an 11 year old female presenting to the Urgent Care with a 9-day history of right hip pain. She reports the pain to be 5/10 on a numerical scale and localized to the right hip without any proximal or distal radiation. The pain is aggravated with activity and relieved with pain medications and rest. She states she was running during a school party and slipped and fell. There was no loss of consciousness. Initially she was transported to an outside ED for evaluation. Her mom states she was advised the X-rays were negative for a right hip fracture. Mom states Joanne was discharged on Tylenol #3 and informated to follow-up with her pediatrician within a week. The following week she presented to the office with worsening right hip pain. She denied fever, night sweats, headaches, abdominal pain, back pain, numbness and tingling in the right lower extremity. PE: BP 105/49, RR 20, HR 74, O2SAT 100% RA. Joanne is well developed, well-nourished young femail appropriate for her age. She guards her right hip and she is unable to bear weight without assistance. There is no pain on palpation and full range of motion (ROM) in all joints of the upper extremities. dorsalis pedis, anterio tibial and posterior tibial pulses are 2+ bilaterally. Exam of the left lower extremity reveals full ROM. Pain is elicited with logrolling of the right hip and palpation near the groin. Muscle strength is 5/5 in the LLE and 3/5 RLE. Assessment: SCFE right hip. Based on this case study:
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