Slipped upper femoral epiphysis

Case contributed by Assoc Prof Frank Gaillard

Presentation

Hip pain.

Patient Data

Age: 14 years
Gender: Male
X-ray

AP and frog-leg view of the pelvis demonstrates mild slip of the left superior upper femoral epiphysis. The right hip appears normal. 

Grading SUFE

Diagram

Pre slip, the earliest detectable change, has normal alignement but a widened growth plate. 

As the epiphysis slips, the metaphysis can be divided into thirds, which allows grading into mild, moderate, and severe. 

  • mild: lateral edge of epiphysis is within the lateral third of the metaphysis
  • moderate: middle third
  • severe: medial third

Line of Klein

Diagram

Line of Klein describes a line along the superior edge of the neck of femur. The line should normally intersect the lateral part of the superior femoral epiphysis. 

In this case the right side is normal (blue line) whereas the left side demonstrates a slip (orange line). 

Case Discussion

Typical appearances of a left sided slipped upper femoral epiphysis. 

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