SUFE Flashcards
what does SUFE stand for
slipped upper femoral epiphysis
what is SUFE
condition mainly affecting overweight pre-pubertal adolescent boys where the femoral head slips inferiorly in relation to the femoral neck
is SUFE common in girls
girls are less commonly affected than boys
what is SUFE associated with
renal disease and hypothyroidism
pathophysiology
the growth plate (physis) is not strong enough to support body weight so the femoral epiphysis slips due to the strain
how many cases are bilateral
one third
presentation
- can be acute, chronic or acute on chronic
- pain and a limp
- pain may be felt in groin
- remembered pain may ONLY be felt in knee (because the obturator nerve supplies the hip and knee joint) so if you don’t examine the hip joint swell you have majorly fucked up
- loss of internal rotation
investigations
AP and lateral x-rays must be obtained as lateral x-rays they can detect minor slips
management
urgent surgery to pin the femoral head, the greater the degree of slip the worse the prognosis
stable and unstable
stable if they can weight bear unstable if they cannot
unstable SUFE is
a medical emergency
sign seen on x-ray in SUFE
Trethowans sign
why is SUFE a misnomer
because the femoral head is in the normal place in the acetabulum it is the femoral neck which moves superior and anteriorly
