- Etiology: posteromedial epiphyseal slip / Salter-Harris Type I fracture due to repeated trauma
- Radiograph: pre-slip – physeal widening is earliest sign, femoral head slips posteromedial (seen better on lateral view), line of Klein drawn over lateral aspect of femoral neck should intersect ~ 1/6th of femoral head, make sure to image both hips for comparison purposes and 25% of cases are bilateral
- MRI: physeal widening, metaphyseal marrow edema adjacent to physis, joint effusion, synovitis, +/- epiphyseal displacement
- Complications: osteoarthritis, avascular necrosis of femoral head, chondrolysis, femoroacetabular impingement, leg length discrepancy
- Treatment: surgically stabilized via screw without reduction of prexisting slip due to increased risk of post operative osteonecrosis associated with slip reduction
- Clinical: presents with hip pain which progresses to limp, seen in older (13 year olds) vs Legg-Calve-Perthes (in 4-8 year olds), 25% bilateral, risk factors – obesity / endocrine / delayed skeletal maturation / family history / hip trauma / decreased femoral anteversion
Radiology Cases of Slipped Capital Femoral Epiphysis



