Slipped capital femoral epiphysis (SCFE)

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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