Slipped upper femoral epiphysis (SUFE)

Case contributed by A.Prof Frank Gaillard

Presentation

Right sided hip pain with no specific traumatic precipitant. Doesn't particularly like sport.

Patient Data

Age: 12
Gender: Male
Modality: X-ray

On the AP view there is very little to see. The line of Klein intersects the epiphysis and the femoral heads are symmetrical. On the flog-leg view, there is clear abnormality on the right with slip of the upper femoral epiphysis (SUFE).

Case Discussion

Features here are of a relatively typical case of SUFE. Some institutions only perform a flog-leg radiograph in patients between the age of 8 and 14 and they are the view to look at first. In patients of this age, never be satisfied with a single AP view.

These patients need urgent referral to the orthopaedic surgeons and need to be on bed rest so that they don't make the slip worse. Surgical treatment is to pin the epiphysis in place (usually without manipulation) and since 10% of cases are bilateral, they often prophylactically pin the contralateral side.

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Case Information

rID: 7984
Case created: 25th Dec 2009
Last edited: 15th Jan 2017
Tag: hip
Inclusion in quiz mode: Included

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