Slip of epiphysis LSBU

Description: 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.