Slipped capital femoral epiphysis

Slipped capital femoral epiphysis
Displacement of proximal femoral epiphysis(epiphysiolysis) is uncommon. Usual age is 14 yrs.; ?:? ratio 3:1. Left ? right;
if one side slips, there is 30% risk for other side to slip.
Etiology: 1-hormonal imbalance (hypogonadism
or hypothyroidism); 2-trauma in 50% of cases.

Pathology: the disruption occurs through hypertrophic zone of the
physis. The femoral shaft rolls into external rotation with femoral
neck displaces anteriorly while the epiphysis remains in the acet.
This usually is associated with tear of anterior retinacular vessels.

CF: a child around puberty who is either fatty &sexually immature
or tall &thin. The condition in 30% of cases is acute &in 70% is
chronic or acute on chronic.
The presentation is painful limping which recurs with exercise.
O/E: short limb &externally rotated with limited ROM.

X-ray: AP view? pass a line(Trethowan s) with upper border of F.
neck ,this normally should intersect part of epiphysis; if not? slip.
Lat. view? the angle between the growth plate & a line through the center of the neck should be 90? ; if less? slip.