Table 2 Pathoanatomic approach; within the greater trochanter triangle (paediatric) (diagnoses appear in order of frequency in an athletic population)

Define and Align	Pathology	Listen and Localise	Palpate and Recreate	Alleviate and Investigate	Define and Align
Within the triangle (Paediatric)	Acute transient synovitis	Male. Refusal to weight bear. Poorly localised pain. Viral precipitant.	3–6 years	Well, non-toxic, variable range of motion.	Diagnosis of exclusion, to be monitored to exclude septic arthritis.22
	Apophysitis/avulsion fracture	Associated injury/event.	<18 years23	Point tenderness.24	Plain film x-ray,25 computerised tomography (CT).26
	Perthes’ disease	Male, associated knee pain.	4–9 years	Decreased range of movement of hip, abduction and internal rotation ↓	Plain film x-ray, antero/posterior (AP), lateral, and comparative views.27
	Perthes’ disease	Male, associated knee pain.	4–9 years	Joint effusion.27
	Slipped capital femoral epiphysis	Overweight, male, 30% cases bilateral.28	12–15 years	Decreased range of motion of hip, abduction and internal rotation ↓.	Plain film x-ray, antero/posterior (AP), lateral, and comparative views.
	Slipped capital femoral epiphysis	Overweight, male, 30% cases bilateral.28	12–15 years	Limb shortening, external rotation of hip.29
	Septic arthritis	Refusal to weight bear. Systemically unwell.	All	Unwell, toxic, variable range of motion.	Temp >38.5, CRP >20, ESR >40, refusal to weight bear, leucocytosis >12.22
	Septic arthritis	Refusal to weight bear. Systemically unwell.	All	Unwell, toxic, variable range of motion.	Plain film x-ray, joint aspiration, isotope bone scan.
	Congenital dysplasia	Delayed mobilising/limp, walking on tip-toe.30	All	Limb length discrepancy, unilateral symptoms, limitation of abduction.30	Ultrasound, x-ray.
	Tumour	Night pain, systemic “red flags”, absence of appropriate physical stressors.20	All ages	Systemic features, may mimic stress fracture.20	Plain film x-ray, magnetic resonance imaging.21