Valgus slipped capital femoral epiphysis with contralateral pre-slip

Skeletal Radiol. 2017 Sep;46(9):1261-1265. doi: 10.1007/s00256-017-2654-1. Epub 2017 Apr 28.

Abstract

Slipped capital femoral epiphysis (SCFE) is a common hip disorder in older children and adolescents, classically with medial and posterior slippage of the proximal femoral epiphysis. However, valgus SCFE is a very rare entity, where the proximal femoral epiphysis slips laterally and posteriorly. To our knowledge, valgus SCFE with magnetic resonance imaging (MRI) features of contralateral pre-slip has not yet been reported. We present a case of a 9 year old girl with symptomatic valgus SCFE on the left and asymptomatic contralateral pre-slip on the right with concurrent radiographic, sonographic, and MRI findings. Such findings include bilateral coxa valga, radiographic irregularity of the left proximal femoral physis, bilateral hip effusions, abnormal MRI signal and enhancement about both proximal femoral physes, and minimal posterolateral slippage of the left proximal femoral epiphysis. We highlight these pertinent imaging findings and review the importance of accurately diagnosing this rare entity for appropriate surgical management.

Keywords: Contralateral pre-slip; SCFE; Slipped capital femoral epiphysis; Valgus.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Fluoroscopy
  • Humans
  • Magnetic Resonance Imaging
  • Pain Measurement
  • Slipped Capital Femoral Epiphyses / diagnostic imaging*
  • Slipped Capital Femoral Epiphyses / surgery
  • Ultrasonography

Substances

  • Contrast Media