Subacute Bacterial Infection Mimicking a Slipped Capital Femoral Epiphysis in an Obese Adolescent Male - A Case Report and Review of Literature

• Published in: Journal of orthopaedic case reports 2023, Vol.13 (5), p.14-19
• Main Authors: Modi, Nihar, Keny, Swapnil, Dave, Harshit, Gandbhir, Viraj, Mishra, Shaswat, Kolur, Shivaprasad
• Format: Report
• Language: English
• ISSN: 2250-0685
• DOI: 10.13107/jocr.2023.v13.i05.3628

IntroductionAtypical and subacute presentations of pediatric bacterial septic arthritis are difficult to diagnose due to lack of systemic manifestations and inadequate laboratory data. Furthermore, they may mimic certain well-documented pediatric disorders to confound the diagnosis and management. Case ReportThe authors present a case of an adolescent obese male with features suggestive of a slipped capital femoral epiphysis (SCFE). Further investigations revealed bacterial septic arthritis which may have contributed to the slip. He was treated with an initial debridement followed by a definitive pelvic support osteotomy (PSO) with a compensatory distal femoral varus osteotomy. At 12 months, he had a satisfactory clinical and radiological outcome. ConclusionClinicians should have a high degree of suspicion for infection in patients presenting with atypical clinical or radiological signs of SCFE. A thorough investigation in such cases is a must, to aid in correct management. PSO is an effective salvage procedure in adolescents with septic hip sequelae.