Diagnostic imaging of the early slipped capital femoral epiphysis.

INTRODUCTION

Early slipped capital femoral epiphysis (ESCFE) can be treated surgically, with excellent results, if it is diagnosed in its initial stage; however, the rate of late or missed diagnoses remains surprisingly high.

PURPOSE: We compared radiography, US and MR sensitivity in ESCFE diagnosis.

MATERIAL AND

METHODS

We examined 21 symptomatic overweight patients (15 boys and 6 girls) aged 9 to 15 years with anteroposterior radiographs; frog leg images were not acquired in 3 cases only. US was performed in 19 cases and the images acquired with 5-7.5 MHz probes on the sagittal plane parallel to the femoral neck. MRI was performed in 9 cases, with coronal and sagittal T1 SE and T2* GE images.

RESULTS

Our sensitivity rates were 66% for anteroposterior radiography (6 false negatives), 80% for combined anteroposterior and frog leg images (3 false negatives), 95% for US (1 false negative) and 88% for MRI (1 false negative).

DISCUSSION AND

CONCLUSION

We believe that US is the method of choice in ESCFE diagnosis; if it is negative, but pain persists, MRI should be performed.