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Slipped capital femoral epiphysis; Other names: Slipped upper femoral epiphysis, coxa vara adolescentium, SCFE, SUFE: X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation. Specialty: Orthopedic surgery Symptoms: Groin pain, referred knee and thigh pain, waddling gait, restricted range of motion of leg: Usual ...
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 AP radiograph of the pelvis. [ 1 ] Clinical use
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.
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
Slipped capital femoral epiphyses (SCFE) Radiographs may show widening and irregularity of the physis and posterior inferior displacement of the capital femoral epiphysis. On the AP view Klein’s line, tangent to the lateral aspect of the femoral neck, does not intersect the femoral head indicating that it is displaced.
Orthopaedic Studio is an application designed to help orthopaedic specialists perform several common quantitative hip examinations that are based on standard x-ray images. The application is implemented as a plugin for the medical image viewer OsiriX and thereby only runs on Mac OS X.