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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.
This study identified that obese children had an almost twenty times greater risk than thin children, with a 'dose-response'- so the greater the weight of the child, the greater the risk of SCFE. In 65 percent of cases of SCFE, the person is over the 95th percentile for weight. [ 2 ]
In addition, an internal rotation of the respective hip joint is either not possible or accompanied by pain when forcefully induced. [2] 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]
A 2011 study analyzing current surgical methods for management of symptomatic femoral acetabular impingement, suggested that the arthroscopic method had surgical outcomes equal to or better than other methods with a lower rate of major complications when performed by experienced surgeons; [32] consequently, the surgery is now rarely done open.
A Southwick angle is a radiographic angle used to measure the severity of a slipped capital femoral epiphysis (SCFE) on a radiograph. It was named after Wayne O. Southwick , a famous surgeon. The angle is measured on a frog lateral view of the bilateral hips.
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).
During childhood, ultrasound is a quick method to assess hip pain and quite often may be used to avoid use of irradiating techniques, such as radiography or CT. Ultrasound allows evaluation of joint effusion, synovial thickening and neovascularity, the bone/cartilage contour, and the femoral head-neck alignment.
Transient synovitis usually affects children between three and ten years old (but it has been reported in a 3-month-old infant and in some adults [3]). It is the most common cause of sudden hip pain and limp in young children. [4] [5] Boys are affected two to four times as often as girls. [5] [6] [7] The exact cause is unknown.