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Slipped capital femoral epiphysis; Other names: Slipped upper femoral epiphysis, coxa vara adolescentium, SCFE, SUFE: X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation. Specialty: Orthopedic surgery Symptoms: Groin pain, referred knee and thigh pain, waddling gait, restricted range of motion of leg: Usual ...
In early skeletal development, a common physis serves the greater trochanter and the capital femoral epiphysis. This physis divides as growth continues in a balance that favors the capital epiphysis and creates a normal neck shaft angle (angle between the femoral shaft and the neck). The corresponding angle at maturity is 135 ± 7 degrees.
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.
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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 ] References
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The angle is measured bilaterally. The slipped side is then subtracted from the normal side. The number calculated determines the severity. Mild is classified by < 30°. Moderate is 30°-50°. Severe is >50°. 12° is the normal control value and can be used in the case of bilateral involvement.