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Diagnostic imaging of the early slipped capital femoral epiphysis.

Magnano GM, Lucigrai G, De Filippi C, Castriota Scanderberg A, Pacciani E, Toma P. Radiol Med (Torino) 1998 Jan-Feb;95(1-2):16-20

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.

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