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SUFE — RACP Paediatrics MCQ

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ModerateEmergencySUFERACP Paediatrics

A 12-year-old overweight boy presents with a 2-week history of left knee and hip pain and a limp. On examination, obligatory external rotation of the hip occurs with passive flexion. He is afebrile. X-ray of the hip shows posterior displacement of the left femoral epiphysis on the frog-leg lateral view. What is the most likely diagnosis?

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Correct answer: E — Slipped upper femoral epiphysis

An overweight adolescent with hip/knee pain, antalgic gait, and obligatory external rotation with hip flexion, with X-ray showing posterior slippage of the femoral epiphysis, is classic for slipped upper femoral epiphysis (SUFE/SCFE). It is more common in males and obese adolescents. The child must be non-weight-bearing and referred urgently for surgical pinning.

Reference: RCH Melbourne – 2023 – Acute Limp CPG; RACP Paediatric Curriculum – Orthopaedics