Young Athlete Slipped Up By Hip Pain

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Young Athlete Slipped Up By Hip Pain - Page #3

Lab Studies: Given the atypical presentation and family history of hypothyroidism, thyroid studies were obtained and were within normal limits with a TSH of 2.57 and free T4 of 1.0. Other Studies: Initial radiographs of the hip were obtained, including AP and frog leg views of the pelvis which showed a slipped capital femoral deformity on the right with epiphyseal widening. On the AP view Case Photo #2 , the Klein line should intersect the lateral portion of the femoral head in a normal hip (as demonstrated on patient's left hip). However, Klein's line is abnormal on the right hip, as it passes at the superior edge of the femoral head without intersection into the femoral head. Additionally, there is slight blurring at the proximal femoral metaphysis, or a metaphyseal blanch sign, which is due to the overlap posteriorly of the metaphysis and epiphysis. On the lateral view Case Photo #3 , the posterior slip of the epiphysis is visible. Consultations: Pediatric Orthopedic surgery was consulted. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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