The right epiphysis has slipped postero-medially with respect to the
metaphysis. Marginal widening of the epiphyseal plate is noted.
Slipped Capital Femoral Epiphysis
Slipped capital femoral epiphysis (SCFE) occurs typically between the ages
of 10 and 17 in boys and 8 and 15 in girls. It is believed that trauma may
play a role in the development of SCFE, especially in younger children.
Other factors include hypothyroidism, acromegaly, gigantism, as well as
other pituitary and parathyroid causes. There is a higher incidence of
SCFE in obese adolescents that may cause an increase in shearing forces on
the growth plate even during normal daily activity.
In the AP view, a line drawn along the superior femoral neck should pass
through the femoral head and the medial contour of the head and neck
should describe a pass through the femoral head, and the medial contour of
the head and neck should describe a continuous arc. With early slipping,
the epiphyseal plate will be widened and the epiphysis will appear
somewhat shortened on the affected side. On the frog-leg lateral view, the
degree of posterior epiphyseal displacement is generally easily seen while
often still not apparent on the AP view. Sequaelae of SCFE include
osteonecrosis, chondrolysis, and degenerative joint disease.
Sanjeev Mani, Bandra Holy Family Hospital, Mumbai