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Children with a SCFE experience a decrease in their range of motion, and are often unable to complete hip flexion or fully rotate the hip inward. [ 10 ] 20–50% of SCFE are missed or misdiagnosed on their first presentation to a medical facility.
The condition is most commonly found in children between the ages of 4 and 10. Common symptoms include pain in the hip, knee, or ankle (since hip pathology can cause pain to be felt in a normal knee or ankle), or in the groin; this pain is exacerbated by hip or leg movement, especially internal hip rotation (with the knee flexed 90°, twisting the lower leg away from the center of the body).
Young children have difficulty determining the location of leg pain, thus in this population, knee pain equals hip pain. [9] SCFE can usually be excluded by an x-ray of the hips. [2] An ultrasound or x-ray guided aspiration of the hip joint maybe required to rule out an infectious process within the hip. [2]
Klein's line or the line of Klein is a virtual line that can be drawn on an X-ray of an adolescent's hip parallel to the anatomically upper edge of the femoral neck.It was the first tool to aid in the early diagnosis of a slipped capital femoral epiphysis (SCFE), which if treated late or left untreated leads to crippling arthritis, leg length discrepancy and lost range of motion.
Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened and the development of a limp. It may be congenital and is commonly caused by injury, such as a fracture.
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In addition, an internal rotation of the respective hip joint is either not possible or accompanied by pain when forcefully induced. [2] The positive Drehmann sign is a typical clinical feature in slipped capital femoral epiphysis (SCFE), the impingement syndrome of the acetabulum-hip, or in osteoarthritis of the hip joint. [3]