A 16 year-old Hemophilia A patient is brought to the ED complaining of back pain and unable to move his right hip. The pain started several days ago following a soccer game. On exam the abdomen is unremarkable, and he holds his right hip flexed with a pillow under his thigh. Any attempt at passive or active extension of the hip causes excruciating back pain. Pain is minimal if patient avoids movement. No distal neurologic findings or saddle hypoesthesia are detectable. Lumbar X-ray is insignificant. What is the best next step for this patient?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.