Rosh Pediatrics Practice Exam

What imaging finding is typically seen in a diagnosis of SCFE?

1. Radiographs showing inferior slip of proximal femoral metaphysis

2. CT scan revealing joint effusion

3. MRI indicating joint capsule disruption

4. X-ray showing aseptic necrosis

The correct answer is: Radiographs showing inferior slip of proximal femoral metaphysis

In the case of slipped capital femoral epiphysis (SCFE), the defining imaging finding is represented by radiographs that show an inferior slip of the proximal femoral metaphysis. This condition occurs when the head of the femur slips off the neck of the femur at the growth plate, leading to characteristic displacement that can be visualized on X-rays. In the imaging, the affected hip joint will display a displacement of the femoral head in a downward and posterior direction relative to the neck, which can often be quantified in degrees. This finding is crucial for making a diagnosis and differentiating SCFE from other conditions that may present with hip pain in children. Other imaging modalities like CT scans or MRIs, although useful in certain contexts, do not specifically highlight the hallmark displacement pattern that radiographs do. CT scans focusing on joint effusion or MRIs depicting joint capsule disruption are relevant in assessing other conditions but are not indicative of SCFE itself. Similarly, X-rays showing aseptic necrosis would point to a different pathology rather than the particular condition of SCFE. Thus, understanding the specific radiographic changes associated with SCFE is essential for accurate diagnosis and subsequent management of this pediatric orthopedic condition.