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Slipped capital femoral epiphysis (SCFE or skiffy, slipped upper femoral epiphysis, SUFE or souffy, coxa vara adolescentium) is a medical term referring to a fracture through the growth plate (physis), which results in slippage of the overlying end of the femur .
In early skeletal development, a common physis serves the greater trochanter and the capital femoral epiphysis. This physis divides as growth continues in a balance that favors the capital epiphysis and creates a normal neck shaft angle (angle between the femoral shaft and the neck). The corresponding angle at maturity is 135 ± 7 degrees.
Klein's line or the line of Klein is a virtual line that can be drawn on an X-ray of an adolescent's hip parallel to the anatomically upper edge of the femoral neck.It was the first tool to aid in the early diagnosis of a slipped capital femoral epiphysis (SCFE), which if treated late or left untreated leads to crippling arthritis, leg length discrepancy and lost range of motion.
The angle is measured on a frog lateral view of the bilateral hips. It is measured by drawing a line perpendicular to a line connecting two points at the posterior and anterior tips of the epiphysis at the physis. A third line is drawn down the axis of femur. The angle between the perpendicular line and the femoral shaft line is the angle.
Trethowan's sign is when Klein's line does not intersect the lateral part of the superior femoral epiphysis on an ... of slipped capital femoral epiphysis. See also ...
The positive Drehmann sign is a typical clinical feature in slipped capital femoral epiphysis (SCFE), the impingement syndrome of the acetabulum-hip, or in osteoarthritis of the hip joint. [ 3 ] References
The condition is most commonly found in children between the ages of 4 and 10. Common symptoms include pain in the hip, knee, or ankle (since hip pathology can cause pain to be felt in a normal knee or ankle), or in the groin; this pain is exacerbated by hip or leg movement, especially internal hip rotation (with the knee flexed 90°, twisting the lower leg away from the center of the body).
Degree of bulging of the femoral head-neck junction: In normal conditions there is a symmetric concave contour at the junction of the femoral head and neck. Loss of this concavity or bone bulging may lead to cam type impingement. The degree of this deformity can be measured by the alpha angle.