A 6-year-old male is referred to physical therapy for hip pain and has been limping for 2 weeks. What is the likely diagnosis?

• A. Transient synovitis
• B. Limping syndrome
• C. Langerhans cell histiocytosis
• D. Legg-Calvé-Perthes Disease (LCPD)

Answer: (D)

Legg-Calvé-Perthes Disease (LCPD) is a pediatric hip disorder characterized by avascular necrosis of the femoral head, leading to hip pain and limping. This condition typically affects children between the ages of 4 and 8 years old, making the 6-year-old boy in this scenario a fitting candidate for this diagnosis.

In LCPD, the blood supply to the femoral head is disrupted, resulting in ischemia and subsequent necrosis. Over time, this can lead to pain, limited range of motion, and a characteristic limp as the child tries to avoid putting weight on the affected hip. Given that the child has been experiencing symptoms for 2 weeks and presents with limping, LCPD is plausible due to its insidious onset and the age group affected.

The other options present conditions that, while they could cause hip pain in children, have different clinical features or age distributions. Transient synovitis often manifests with an acute onset of hip pain and limping, typically after a viral infection, leading to a more immediate and shorter symptom duration. Limping syndrome is a broader term not specific to an underlying pathology and does not pin down the likely diagnosis. Langerhans cell