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Children with a SCFE experience a decrease in their range of motion, and are often unable to complete hip flexion or fully rotate the hip inward. [ 10 ] 20–50% of SCFE are missed or misdiagnosed on their first presentation to a medical facility.
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.
Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened and the development of a limp. It may be congenital and is commonly caused by injury, such as a fracture.
Children with autosomal dominant MED experience joint pain and fatigue after exercising. Their x-rays show small and irregular ossification centers, most apparent in the hips and knees. There are very small capital femoral epiphyses and hypoplastic, poorly formed acetabular roofs. [1] A waddling gait may develop.
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]
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.
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).
Generally, radiation therapy should be delivered as close as practical to the time of surgery. A dose of 7-8 Gray in a single fraction within 24–48 hours of surgery has been used successfully. Treatment volumes include the peri-articular region, and can be used for hip, knee, elbow, shoulder, jaw or in patients after spinal cord trauma.