Slipped upper femoral epiphysis

Headline
Etiology Displacement of proximal femoral epiphysis
Epidemiology Risk factors: overweight, boys age 10-16, endocrine abnormalities
Clinical presentation Sudden onset limp +/- minor trauma, leg held in ext rotation
Pathogenesis
Diagnostic investigations Frog-leg XR: widening of epiphyseal line
- Trethowan's sign = Klein's line (line running along superior edge of femoral neck) crosses above femoral head instead of femoral epiphysis
Management NWB → admit for surgical fixation
Single screw to stabilise

Example X-rays:
https://radiopaedia.org/cases/slipped-upper-femoral-epiphysis-sufe
https://radiopaedia.org/cases/slipped-upper-femoral-epiphysis-pre-and-post-pinning

#paeds #musculoskeletal

https://bestpractice.bmj.com/topics/en-gb/757