He Walks Funny

Jean Ivey, DSN, CRNP; Linda Wilkinson, MSN, RN, CRNP; John Killian, MD, AAOS

Disclosures

Pediatr Nurs. 2008;34(6) 

In This Article

Physical Examination

VS: T 99, R 24, HR 85, BP 100/60.

Weight: 45 lbs.(> 95%); Height 38 inches (95%) BMI 22.

General: Pleasant and talkative, able to converse, answers questions readily, appropriate development for age. Has a 6-week-old sister, who is healthy.

HEENT: Normocephalic, scalp clean without lesions, no lymphadenopathy, Eyes: Sclera white, no discharge, red reflex symmetrical both eyes. Ears: TMs dark red, mobile, landmarks visible, light reflex present. Mouth: mucosa deep pink, palate intact, no dental caries, tonsils 2+, no exudate, uvula mobile, positive gag reflex.

Cardiovascular: Heart rate and rhythm regular, no murmurs, pulses symmetrical and full.

Respiratory: Bilateral breath sounds clear to auscultation, respiratory excursion symmetrical.

Musculoskeletal: Full range of motion of upper extremities, muscle tone firm, equal strength. Left hip has full range of motion (ROM), no pain, joint non-tender, moves upper and lower leg without limitation but with a Trendelenberg gait. Right hip has limited abduction but no pain over the femoral head. Stands on both feet, no scoliosis or lordosis. Positive Galeazzi sign. Full range of motion bilaterally in knees and ankles, no pain or tenderness. Muscle strength and tone in lower extremities seems unimpaired.

Neurological: DTRs 2+, symmetrical, Cranial nerves I-XII intact. Alert, responds appropriately. Rhomberg negative. Visual tracking seems normal for age. Sensation and discrimination appropriate.

Diagnostic tests: WBC with differential and sedimentation rates, A-P and frog leg lateral X-ray of pelvis. An MRI was deferred to the orthopedist, but this could have contributed to the diagnostic workup.

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