A 13-year-old boy has a shorter lower extremity with ipsilateral thigh and hip pain. When walking, the involved hip is MOST likely maintained in which position?

A 13-year-old boy has a shorter lower extremity with ipsilateral thigh and hip pain. When walking, the involved hip is MOST likely maintained in which position?

• A. Flexion
• B. Abduction
• C. Medial (internal) rotation
• D. Lateral (external) rotation

Answer: (D)

This presentation fits slipped capital femoral epiphysis (SCFE), a condition common in adolescents who have a limp, thigh or hip pain, and a leg that appears shortened. The slip causes the femoral head to move posteriorly and inferiorly through the growth plate, which makes internal rotation painful and limited. To minimize discomfort and stabilize the limb during walking, the hip tends to rest in external (lateral) rotation. Flexion or abduction aren’t the posture that best describes how the hip sits during gait in this condition, and internal rotation is typically restricted rather than the resting position.

This presentation fits slipped capital femoral epiphysis (SCFE), a condition common in adolescents who have a limp, thigh or hip pain, and a leg that appears shortened. The slip causes the femoral head to move posteriorly and inferiorly through the growth plate, which makes internal rotation painful and limited. To minimize discomfort and stabilize the limb during walking, the hip tends to rest in external (lateral) rotation. Flexion or abduction aren’t the posture that best describes how the hip sits during gait in this condition, and internal rotation is typically restricted rather than the resting position.