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- Transphyseal displacement of the upper femoral epiphysis from the metaphysis.
- X-ray Views: Frog lateral (More sensitive) and AP x-rays
- Acutely may see inferoposterior slip (best seen on LAT view).
- Trethowan sign: Klein’s line along sup. border of the femoral neck should intersect femoral head
- Widening and irregularity of the physis
- Limping (remember DDx)
- Groin, thigh or knee pain.
- Symptoms acute or chronic
- Early teens (10-17), M>F, obesity, chronic renal disease
- The leg may be held slightly adducted, externally rotated and shortened.
- On examination, reduced ROM flexon, abduction and especially internal rotation
- Beware bilateral disease is common
- Stable slip – no weight bearing refer ortho for possible internal fixation
- Unstable – admit today for internal fixation
- AVN (avascular necrosis) of the femoral head
- Degenerative hip arthritis
- limb length discrepancy
- Legg-Calve-Perthes disease
- septic arthritis
- transient synovitis
- developmental dysplasia