Right hip & knee unable to bear weight - 14 year old boy

[Yellow_Bird]

My 14 year old son had a fall playing basketball one year ago.  He had pain in the right hip and was xrayed and no fracture or dislocation was seen.  He rested for 3 days and returned to school.  After this he started limping everytime he played football and I did not relate the limp to the fall as the xrays were clear.  He did not want to go to school because of leg pain so I stopped the football, suspecting that he was using this as an excuse to stay home from school. The limp recurred again at the end of 2009 when he resumed football and by February 2010 it became very noticable.  Coupled with the limp, he had stomach pains.  He went to doctors and specialists and had various tests done including ultrasound, MRI, bone scan, CAT scan and more xrays.  At first he was diagnosed with appendicitis but I requested a 2nd opinion as he had no fever, vomiting or severe stomach pain, they diagnosed him with IBS. His diet was modified but the stomach pains continued and the limp got worse until the middile of March when he had to use crutches to move around. He was referred to the Hospital for Sick Kids where he was diagnosed with a PRE Slipped Capital Femoral Epiphysis.  The pinning was done in our own city (Barbados) on April 21, 2010 but after the surgery we noticed that he still cannot bear weight on the right leg and is still on crutches.  The hip gives way when he tries to put weight on it and the knee buckles.

He is now going to be tested for Crohn's disesase but I do not feel this is what is wrong.  Can anyone help me get a correct diagnosis for my son?

[Yellow_Bird]

Thanks for your prompt reply.  My son is being tested for Crohn's because of the joint pain and in the past he had stomach pains and diarhhoea.  Like me, the gastroenterologist he is seeing at the moment does not believe he has Crohn's because he has not lost weight, still has good appetite and the diarhhoea and stomach pains have settled dwon.

This morning he had a small bowel series done and the results were nromal.  He has seen an orthopedic doctor in Barbados who sent him for a bone scan.  The scan only showed a thickening of the pelvi bone and all the doctor said was repeat the scan in 3 months.  In the meantime my son progressed to crutches and was referred by his pediatrician to Sick Kids.

There he was first diagnosed with muscle pull (which did not add up as the problem has been going on for a year now) and then the orthopedic specialist said it was a possible pre slip capital femoral epiphysis and recommended pinning.

This was done last week in Barbados by the best orthopedic surgeon on the island - one recommended by Professor Wright at Sick Kids, but unfortunately the groin pain and pain behind the knee has not gone away and my son is still on cructhes because his right leg cannot bear weight.

[Dr Vinod]

Hello!

Crohn's disease is an inflammatory disease of the digestive tract.

IBS is a much less serious problem called a functional disorder.

IBD or inflammatory bowel disease causes ulcerative colitis.

Arthritis is present with both Crohn's disease and ulcerative colitis.

I would suggest you to properly get your son's condition diagnosed and for this follow up with a gastroenterologist. The primary cause is important to treat.

An orthopedician can help with orthopedic complications.

Take care!