What are 5 early features on plain films?
Asymmetry, apparent increase in density, medial joins space widening, blurring of the growth plate margins, and metaphyseal lucency.
What are some of the differential diagnoses?
Slipped superior femoral epiphysis (SUFE); osteomyelitis; secondary causes of avascular necrosis (AVN); dysplasia epiphysealis capitis femoris (Meyer dysplasia); juvenile rheumatoid arthritis (JRA)
The left superior femoral epiphysis is markedly flattened, sclerotic and appear to be undergoing fragmentation. Alignment is unremarkable and the pelvis and acetabulum appear normal.
The right hip appears normal.