Slipped capital femoral epiphysis: Difference between revisions
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===Presentation=== | ===Presentation=== | ||
*Mild to severe pain hip pain (may have referred knee pain) | *Mild to severe pain hip pain (may have referred knee pain) | ||
*Limp | *abnormal gait | ||
*Limp, weakness, thigh atrophy | |||
*externally rotated | |||
*loss of internal rotation, abduction, and flexion | |||
*May present as acute, chronic, or acute on chronic (following trauma) | *May present as acute, chronic, or acute on chronic (following trauma) | ||
===Imaging=== | ===Imaging=== | ||
*AP, Frog Leg Lateral View B/L | *AP, Frog Leg Lateral View B/L | ||
Revision as of 16:46, 29 December 2014
Background
- Most common cause of hip disability in adolescents
- Head of femur displaces from epiphysis
- Complications: avascular necrosis, arthritis
Risk Factors
- Obesity
- African-American
- Male:female (3:1)
- During growth spurt (m=13y f=11y)
- L Hip more common
- Associated w/ Endocrine Disorders
- hypothyroid common
- high clinical concern for <10 yrs of age
DDX
Diagnosis
Presentation
- Mild to severe pain hip pain (may have referred knee pain)
- abnormal gait
- Limp, weakness, thigh atrophy
- externally rotated
- loss of internal rotation, abduction, and flexion
- May present as acute, chronic, or acute on chronic (following trauma)
Imaging
- AP, Frog Leg Lateral View B/L
- Widened physis (early finding)
- Displacement of femoral neck to head (late finding)
- Frog Leg view of both sides: high proportion have b/l involvement
- Klein's line
- Line from superior cortex of femoral neck parallel to greater trochanter
- Normally should cross through 1/3 of femoral head
- Line from superior cortex of femoral neck parallel to greater trochanter
Treatment
- Orthopedic consultation in ED
- MRI for ambiguous cases
- Non-weight bearing
- Internal fixation
Disposition
Admission
See Also
Source
Tintinalli