Full Answer Section

• The severity of their symptoms: I will describe the intensity or impact of their symptoms as indicated by the patient’s description (e.g., mild, moderate, severe; impacting daily activities, etc.).

Looking back at our previous conversation, the only patient scenario we discussed in detail was Brenda, the 13-year-old with a limp. If you’re referring to Brenda, here’s the information she provided:

• Chief Complaint: Left leg limp.
• Symptomology:
  • Developed last week (duration).
  • No history of injury.
  • Can bear weight on her left leg.
  • Complains of left hip, groin, and knee pain when she does bear weight (location).
  • Brenda’s BMI is >95% (relevant risk factor).
  • Past medical history unremarkable.

Based on these details, the differential diagnosis leaned heavily towards Slipped Capital Femoral Epiphysis (SCFE) due to:

• Adolescent age (13 years old): SCFE is most common in this age group.
• Obesity (BMI >95%): A significant risk factor for SCFE.
• Insidious onset (developed last week, no specific injury): SCFE often presents with a gradual onset of symptoms.
• Referred pain (hip, groin, and knee pain): Pain in SCFE can be referred to the thigh and knee.
• Limp with weight-bearing: Indicating a musculoskeletal issue affecting gait.

The duration of Brenda’s symptoms was one week, and the severity, while allowing her to bear weight, was significant enough to cause a limp and pain in multiple locations, prompting her mother to bring her to the clinic.