OWL: OCOSH Classification/Bone Diseases/Slipped Epiphysis

A Patients Guide to Slipped capital Femoral Epiphysis

Randale Sechrest — 2007-07-17 00:53:59 GMT

Detailed and well illustrated information

Avoiding Screwhead Impingement in Slipped Capital Femoral Epiphysis

Not Available — 2007-07-17 00:53:59 GMT

Report of an article on the subject.

Bilateral slipped capital femoral epiphysis occuring in an adult with acromegalic gigantism

Feydy et al — 2006-11-16 00:53:59 GMT

Abstract The etiology of slipped capital femoral epiphysis is still unknown. Traumatic, endocrine, toxic, and mechanical causes have all been hypothesized. It is well documented that the highest incidence occurs during the adolescent growth spurt, suggesting the role of an endocrine abnormality. We report a case that supports this hypothesis Skeletal Radiology Volume 26, Number 3 / March, 1997 Authors A. Feydy, R. Y. Carlier, D. Mompoint, G. Rougereau, A. Patel, C. Vall�e

Case 33. Bilateral Slipped Capital Femoral Epiphysis.

Not Available — 2002-02-04 00:53:59 GMT

BILATERAL SLIPPED CAPITAL FEMORAL EPIPHYSIS

Childs Hip - Pathologic disorders

C.R.Wheeless — 2002-02-04 00:53:59 GMT

Links to notes on
DDH
Effusion - diff. dx
Perthes Disease
Sickle Cell Anemia
Slipped Capital Femoral Epiphysis
Wheeless' Textbook of Orthopaedics

Delay in diagnosis of slipped upper femoral epiphysis

Ankarath et al — 2007-07-17 00:53:59 GMT

J R Soc Med. 2002 July; 95(7): 356�358. (full text)
Treatment of slipped upper femoral epiphysis (SUFE) is directed at preventing progressive slippage, minimizing deformity and avoiding avascular necrosis and chondrolysis. Delay in treatment adversely affects long-term outcomes. In a retrospective study we assessed delays between symptom onset and evaluation of the patient in an orthopaedic department. 27 patients aged 10-16 years were grouped by source of referral (general practitioner or accident and emergency department), and hips were classified as stable or unstable according to ability to bear weight. The 27 children had 37 affected hips, 31 stable and 6 unstable. In the 20 patients referred by general practitioners, mean delay from symptom onset to orthopaedic evaluation was 119 days (range 2-504); in the 7 referred from accident and emergency departments it was 95 days (1-482). In the latter group the slips were more likely to be acute and unstable. 9 (45%) of the patients in the general-practitioner group had hip radiography before referral, all correctly diagnosed though not all the examinations included the recommended frog-lateral views. Long delays between onset and diagnosis of SUFE are most likely in patients with mild symptoms, able to bear weight on the hip. Any adolescent with undiagnosed hip or knee pain that has lasted more than a week should undergo radiological investigation of the hip, with frog-lateral as well as anteroposterior views.

Femoral head re-orientation in SCFE through a surgical hip dislocation VuMedi

Reinhold Ganz — 2011-04-29 00:53:59 GMT

Femoral head re-orientation in SCFE through a surgical hip dislocation. By: Reinhold Ganz
In this (20 min) video we present the surgical technique to treat SCFE trough a surgical dislocation of the hip.

Genu recurvatum in association with slipped capital femoral epiphysis

Gibson — 2007-07-17 00:53:59 GMT

J R Soc Med. 1981 August; 74(8): 626�627
P H Gibson Full text

Nonoperative treatment of slipped capital femoral epiphysis

Pinheiro — 2011-04-15 00:53:59 GMT

Conclusions After analyzing the nonoperative treatment of slipped capital femoral epiphysis and chondrolysis, we conclude that employment of the treatment revealed that the method was functional, efficient, valid, and reproducible; it also can be used as an alternative therapeutic procedure regarding to this specific disease.
Nonoperative treatment of slipped capital femoral epiphysis: a scientific study Pinheiro PCMS Journal of Orthopaedic Surgery and Research 2011, 6:10 (full text)

Old slip of femoral epiphyses LSBU

IDM — 2002-01-31 00:53:59 GMT

Radiology case 448-4146 31 year old man with pain in both hips and inability to walk, originally from India.
There is distortion and flattening of the heads of both femora. There is lateral migration so that the neck of each femur no longer points to the centre of radius of the related acetabulum. The hip joint margins are sclerotic and irregular with sub-articular cyst formation. There is osteophytic lipping at the acetabular margins. On the left side, there are linear ossific densities, that are projected in the area of collateral ligaments of the left hip.

Radiology Cases Slipped Epiphysis

IDM — 2009-07-29 00:53:59 GMT

Slip of Femoral capital epiphysis.
The length and angle of the neck of the Femur is useful for an erect hominid, especially when carrying things. Standing, the curves of both femora, pelvic rings and sacrum conduct the lines of force up into the spine. Moving requires the support to come from one side. The pelvis is tilted by the actions of the glutei (particularly Medius). It then becomes possible for the lines of force to be outside the centres of femoral neck and hip-joint. Shear forces may operate across the junction of femoral capital epiphysis and femoral neck. Activity and obesity may both increase these forces, explaining why boys were more likely to get this condition, especially when obese. Peak incidence is in early adolescence. The epiphysis is displaced backwards and medially, relative to the metaphysis (regarded as the fixed point, when standing). Since the pelvis and lower limbs are supposed to be symmetrical, the presence of one abnormality should alert the reader to subtle abnormality on the other side. The total incidence is of 20 to 40% of cases having bilateral slip, sooner or later.
Signs of slip include:
* Loss of height of epiphysis in projected image.
* Loss of width of epiphyseal plate in projected image.
* There is a reduction of that medial part of the metaphysis, normally within the acetabulum in the neutral view.
* The projected lateral margin of the metaphysis no longer intersects the epiphysis.
* Rotation of the pelvis towards the abnormal, stiffer, joint in a supine view (diverging rays).

Slip of epiphysis LSBU

IDM — 2002-01-31 00:53:59 GMT

Radiology case 443-4146 Clinical presentation: Male aged 13 years. There is no recorded history of obesity or particularly active pursuits. The femoral neck is not lined up with the curve of the left acetabulum, the left epiphysis is shortened and displaced backwards and is projected infero-medially in this view. The left epiphysis no longer protrudes a little beyond the outer margin of the femoral neck. Almost one third of the area of the epiphysis now protrudes medially outside of the right acetabulum. The epiphyseal plate appearance is changed with narrowing. The appearance differs in all these points from the normal right hip. The child is in the age-group (10-14yrs). There is a band of bone density in the neck of the left femur, separate from the epiphyseal line, that may represent a stress reaction to the changed mechanical loads. Inset shows later pinning.

Slipped Capital Femoral Epiphysis

FamilyDoctor.org — 2002-01-11 00:53:59 GMT

Overview with answers to commonly asked questions about this limping condition

Slipped Capital Femoral Epiphysis

Thomas Joseph MD — 2002-01-11 00:53:59 GMT

Overview of this limping condition including causes, symptoms, and treatment

Slipped Capital Femoral Epiphysis

Not Available — 2002-01-11 00:53:59 GMT

AAOS Online Service Fact Sheet Slipped Capital Femoral Epiphysis