Missed slipped capital femoral epiphysis: Illustrative cases and a review

Causey, Alan L.; Smith, E.Ross; Donaldson, Jill; Kendig, Ronald J.; Fisher, Luther C.

doi:10.1016/0736-4679(94)00139-1

Cited by 32 publications

(14 citation statements)

References 48 publications

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“…1,8,15,16,22 The implications of a delay in diagnosis of SCFE are profound, because delay is associated with greater slip severity, and greater slip severity is associated with higher risk of short-term treatment complications and poorer longterm hip outcome, including degenerative joint disease. [1][2][3][4][5][6][7][8][9][10][11] Focused intervention programs to reduce the delay in diagnosis of SCFE should emphasize patients with knee/thigh pain and patients with Medicaid coverage.…”

Section: Discussionmentioning

confidence: 99%

Delay in Diagnosis of Slipped Capital Femoral Epiphysis

et al. 2004

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ABSTRACT. Objective. Delay in diagnosis of slipped capital femoral epiphysis (SCFE) has important implications in terms of slip severity and long-term hip outcome. The purpose of this study was to identify predictors of delay in the diagnosis of SCFE.Methods. A review of 196 patients with SCFE was performed. The primary outcome measure was delay from onset of symptoms to diagnosis. Covariates included age, gender, side, weight, pain location, insurance status, family income, slip severity, and slip stability. Delay in diagnosis was not normal in distribution; therefore, nonparametric univariate and multivariate analyses were performed.Results ABBREVIATION. SCFE, slipped capital femoral epiphysis.

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Section: Discussionmentioning

confidence: 99%

Delay in Diagnosis of Slipped Capital Femoral Epiphysis

et al. 2004

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“…In spite of what many believe have been improvements in the medical care system over time, the average duration of symptoms before the diagnosis of a slipped capital femoral epiphysis has changed little over many decades, and the diagnosis is still enigmatic 3,[8][9][10] . It is also known that the long-term outcome of slipped capital femoral epiphysis is directly related to the slip severity 1 and the presence or absence of complications, primarily osteonecrosis and/or chondrolysis 1,11,12 .…”

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confidence: 94%

Demographic Predictors of Severity of Stable Slipped Capital Femoral Epiphyses

Loder

Starnes

Dikos

et al. 2006

J Bone Joint Surg Am

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“…Frontal and “frog-leg” lateral radiographs are the most important imaging studies for the diagnosis, and should include both hips, because of the high incidence of bilateral slip [4]. The earliest radiographic finding on the frontal view is a widening and irregularity of the femoral capital physis.…”

Section: Discussionmentioning

confidence: 99%

“…The earliest radiographic finding on the frontal view is a widening and irregularity of the femoral capital physis. The Klein’s line, drawn on the AP view along the superior aspect of the femoral neck, does not intersect the femoral head in SCFE [4,5]. The ‘metaphyseal blanch’ sign may also be seen [2].…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Diagnosis of Slipped Capital Femoral Epiphysis

2018

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SummaryBackgroundSlipped capital femoral epiphysis (SCFE), a fracture through the physis with resultant slip of the epiphysis, is the most common hip abnormality in adolescents and is a major cause of early osteoarthritis. Plain radiograph is the initial modality used to evaluate patients with painful hip joints. Ultrasonography and magnetic resonance imaging (MRI), which do not involve radiation exposure, have also been used. This case report supports the view that ultrasound can be used as an initial, cost-effective and radiation-free modality for the evaluation of suspected SCFE.Case ReportA 15-year-old male patient presented with pain in the right hip for 5 days, following a slip and fall accident while playing soccer. The patient was referred to the Department of Radio-diagnosis for ultrasound. A posterior displacement of the femoral head epiphysis with a physeal step was seen on the longitudinal section obtained over the right hip joint region. The anterior physeal step (APS) measured ~3.8 mm on the right side. The distance between the anterior rim of the acetabulum and the metaphysis measured ~20.4 mm on the affected right side and ~23.6 mm on the left side. A plain radiograph in frog leg position showed a widening of the right proximal physis below the right femoral head, with a medial and posterior slip of the right femoral head. A frontal radiograph of the pelvis taken six months before showed a widening of the proximal right femoral physis.ConclusionsAlthough MRI appears to be the most sensitive modality for identifying slips early, ultrasound may be used as a cost-effective and radiation-free alternative before proceeding with further evaluation of suspected SCFE, especially considering the demographics of the affected population.

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Missed slipped capital femoral epiphysis: Illustrative cases and a review

Cited by 32 publications

References 48 publications

Delay in Diagnosis of Slipped Capital Femoral Epiphysis

Delay in Diagnosis of Slipped Capital Femoral Epiphysis

Demographic Predictors of Severity of Stable Slipped Capital Femoral Epiphyses

Ultrasonographic Diagnosis of Slipped Capital Femoral Epiphysis

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