A 12-year-old obese boy presents with a limp and pain referred to the ipsilateral knee. Hip examination shows painful restriction of internal rotation and obligatory external rotation on flexion. X-ray of the pelvis shows a Klein's line not passing through the femoral head. The diagnosis is:

• A Perthes disease
• B Developmental dysplasia of the hip
• C Transient synovitis of the hip
• D Slipped capital femoral epiphysis ✓

Explanation

Slipped capital femoral epiphysis (SCFE) classically affects obese boys around the time of puberty (10–14 years). The femoral epiphysis slips posteriorly and inferiorly on the neck. On an AP radiograph, Klein's line (a line along the superior femoral neck) normally transects part of the epiphysis; failure to do so indicates a slip. Pain referred to the knee is a classic presentation. Treatment is urgent surgical pinning with a single cannulated screw to prevent further slippage and AVN.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.