Slipped Capital Femoral Epiphysis vs Legg-Calvé-Perthes Disease
Slipped Capital Femoral Epiphysis and Legg-Calvé-Perthes Disease are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Slipped Capital Femoral Epiphysis vs Legg-Calvé-Perthes Disease at a glance
- Slipped Capital Femoral Epiphysis: Posterior and inferior displacement of the femoral epiphysis on the metaphysis in adolescents.
- Legg-Calvé-Perthes Disease: Idiopathic avascular necrosis of the proximal femoral epiphysis in children aged 4-8.
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Side-by-side comparison
| Feature | Slipped Capital Femoral Epiphysis | Legg-Calvé-Perthes Disease |
|---|---|---|
| At a glance | Posterior and inferior displacement of the femoral epiphysis on the metaphysis in adolescents. | Idiopathic avascular necrosis of the proximal femoral epiphysis in children aged 4-8. |
| Classic presentation | Obese adolescent with insidious thigh or knee pain, limp, and obligate external rotation of the hip during flexion.; Insidious or acute hip, groin, thigh, or… | Young boy aged 4-8 with a painless limp, restricted internal rotation and abduction of the hip, and characteristic crescent sign or femoral head flattening on… |
| Workup / key labs | Loder classification (functional, prognostic): Stable — patient can bear weight with or without crutches; Unstable — cannot bear weight even with crutches.… | Lateral pillar (Herring) classification at the fragmentation stage assesses the height of the lateral one-third of the epiphysis: A — full height preserved… |
| Imaging | AP and frog-leg lateral radiographs of BOTH hips (synchronous bilateral disease); Klein line — line drawn along the superior femoral neck on AP view should… | AP and frog-leg lateral pelvic radiographs; Early findings: increased epiphyseal density, joint space widening, crescent sign (subchondral fracture); Later… |
| First-line treatment | Immediate non-weight bearing and orthopedic referral upon suspicion — NEVER allow continued weight bearing while awaiting evaluation; Surgical in situ pinning… | Activity restriction to limit hip joint loading and protect the femoral head during fragmentation; NSAIDs for pain; Physical therapy emphasizing hip range of… |
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