A 12-year-old obese boy presents with right hip pain radiating to the knee and a limp for 3 weeks. On examination, when the hip is flexed, it also goes into external rotation and cannot be internally rotated. X-ray shows widening of the physis and posterior-inferior displacement of the capital epiphysis. The diagnosis is:

• A Slipped capital femoral epiphysis (SCFE) ✓
• B Perthes disease (Legg-Calvé-Perthes)
• C Transient synovitis of the hip
• D Developmental dysplasia of the hip (DDH)

Explanation

SCFE occurs most commonly in obese adolescent males (10–16 years) as a Salter-Harris Type I fracture through the hypertrophic zone of the capital physis. The femoral head slips postero-inferiorly while the metaphysis rotates anteriorly, producing obligate external rotation with hip flexion (the pathognomonic sign). Treatment is emergent percutaneous in-situ pinning with a single cannulated screw to prevent further slip and AVN. Chondrolysis is a complication of cartilage penetration by the screw.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.