Question
Diagnose the orthopaedic disorder shown in the photograph below ?
A. Coxa vara.
B. Slipped capital femoral epiphysis.
C. Perthe’s disease.
D. Fracture acetabulum.
|
Correct Answer » B Explanation |
 |
The line marked in the picture above represents Trethowan’s line.The Trethowan sign is used to diagnose slipped capital femoral epiphysis.
Slipped capital femoral epiphysis (SCFE) is a hip condition that occurs in teens and pre-teens who are still growing. For reasons that are not well understood, the ball at the head of the femur (thighbone) slips off the neck of the bone in a backwards direction. This causes pain, stiffness, and instability in the affected hip. The condition usually develops gradually over time and is more common in boys than girls.
The cause of SCFE is not known. The condition is more likely to occur during a growth spurt and is more common in boys than girls.
Risk factors that make someone more likely to develop the condition include:
- Excessive weight or obesity—most patients are above the 95th percentile for weight
- Family history of SCFE
- An endocrine or metabolic disorder, such as hyperthyroidism—this is more likely to be a factor for patients who are older or younger than the typical age range for SCFE (10 to 16 years of age)
Symptoms of SCFE vary, depending upon the severity of the condition.
A patient with mild or stable SCFE will usually have intermittent pain in the groin, hip, knee and/or thigh for several weeks or months. This pain usually worsens with activity. The patient may walk or run with a limp after a period of activity.
In more severe or unstable SCFE, symptoms may include:
- Sudden onset of pain, often after a fall or injury
- Inability to walk or bear weight on the affected leg
- Outward turning (external rotation) of the affected leg
- Discrepancy in leg length—the affected leg may appear shorter than the opposite leg.
