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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.
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.
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).
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]
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.
The Children’s Health Insurance Program was created in 1997 and reauthorized in 2009. Known as CHIP, the program was enacted following the 1994 failure of national health reform. The purpose of CHIP was to expand health insurance coverage for targeted, uninsured, low-income children with family incomes below 200 percent of the federal poverty ...
There are typically four classes (or types) of PFFD, ranging from class A to class D, as detailed by Aitken. [4] [5]Type A — The femur bone is slightly shorter on the proximal end (near the hip), and the femoral head (the ball of the thigh bone that goes into the hip socket) may not be solid enough to be seen on X-rays at birth, but later hardens (ossifies).
Treatment is often dependent on the duration and severity of the pain and dysfunction. In the acute phase (first 1–2 weeks) for a mild sprain of the sacroiliac, it is typical for the patient to be prescribed rest, ice/heat, spinal manipulation, [ 35 ] and physical therapy; anti-inflammatory medicine can also be helpful.