Case report

A two year old boy presented with pain in his right leg. Three weeks earlier he had had tonsillitis, fever, and diarrhoea. His doctor had treated him with amoxycillin, and his symptoms subsequently settled. The pain in his leg started two days before admission. He limped and was reluctant to walk. The pain was precipitated by walking and was vaguely localised to the hip. He had no other joint symptoms or relevant history. On examination he was apyrexial but irritable. He had difficulty sitting and refused to stand or weight bear. Neurological examination revealed intact cranial nerves, although the gag reflex was depressed, which was partly attributed to his uncooperative behaviour. However, there was no indication …