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Slipped upper femoral epiphysis

Diagnosis certain

Presentation

Obese adolescent presenting with left hip pain, limping and limitation in the range of motion, besides the inability to bear weight after accidentally falling into a hole.

Patient Data

Age: 14 years
Gender: Male

Preoperative x-ray study

x-ray

Left femoral epiphysis presents widening of the growth plate with irregularity and blurring of the physeal edges, slight sclerosis of the metaphysis, and mild posteromedial slip.

Left femur demonstrates Trethowan sign.

The alterations are compatible with slipped upper femoral epiphysis (SUFE).

Preoperative CT study

ct

Mild SUFE in left femur.

Postoperative x-ray study

x-ray

1 day after surgery.

Postoperative x-ray study

x-ray

14 days after surgery.

Case Discussion

Slipped upper femoral epiphyses (SUFE) is the most common hip disorder in children from 9 to 15 years old, especially boys. One of the proven related biomechanical factors is obesity; all of these characteristics were presented by the patient in this case.

Contributed by Dr. Guilherme Pioli Resende M.D. and Dr. Arthemizio Antônio Lopes Rocha M.D.

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