A 12-year-old obese boy presents with right hip pain and limp. X-ray shows posterior-inferior displacement of the femoral epiphysis on the metaphysis. This is slipped capital femoral epiphysis (SCFE). The steel angle (epiphyseal-shaft angle) is 40°. This is classified as:
- A Grade II (moderate) — slip 33–50% ✓
- B Grade I (mild) — slip <33%
- C Grade III (severe) — slip >50%
- D Grade IV — complete slip with physeal closure
Correct answer: A. Grade II (moderate) — slip 33–50%
Explanation
SCFE grading by Steel's head-shaft angle: Grade I (mild) <30°, Grade II (moderate) 30–60°, Grade III (severe) >60°. Alternatively, the percentage slip: Grade I <33%, Grade II 33–50%, Grade III >50%. With a Steel angle of 40°, this falls within Grade II (moderate). Management is urgent surgical stabilization with in-situ pinning using a single cannulated screw through the physis (without attempted reduction for stable SCFE) to prevent further slip and subsequent avascular necrosis from manipulation.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.