Presentation
Right hip pain since 6 months. No trauma.
Patient Data
Coronal, axial and sagittal images of right hip joint in a 16 year old male adolescent child show posterior and medial subluxation of femoral head epiphysis over the metaphysis, suggestive of slipped capital femoral epiphysis (SCFE). There is irregularity of upper right femoral growth plate with subtle marrow edema (STIR hyperintense signals).
Posterior subluxation is most evident on sagittal images.
Moderate right hip joint effusion is noted.
Left hip joint is normal.
Case Discussion
16 year old adolescent boy presented with right hip pain. MRI of hip joints showed postero-medial subluxation of right femoral head epiphysis over the metaphysis. There is irregularity and subtle marrow edema of epiphysis and metaphysis towards the growth plate. Moderate right hip joint effusion is also noted.
These features are suggestive of slipped capital femoral epiphysis (SCFE).
SCFE is commonly seen in overweight adolescents with increased physical activity. It is a type of type I Salter Harris fracture.
AP and frog-leg views of the affected hip joint are the first imaging tools for diagnosis SCFE. Frog-leg view is particularly helpful as the initial displacement of upper femoral epiphysis is in posterior direction; hence easily missed on AP radiographs.
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