Slipped Upper Femoral Epiphysis – Board-Style Questions

What this deck covers

slipped upper femoral epiphysis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. His build
2. Where it hurts
3. Bending the hip
4. How he walks
5. Drawing a line
6. A normal first film
7. A long story
8. Too young for this
9. Another cause to seek
10. Stable or not
11. Before theatre
12. The operation done
13. What not to do
14. The worst outcome
15. A stiffening joint
16. The second hip
17. How long to watch
18. Trouble years later

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A history of repeated ankle injury while playing sport, Pain felt at the knee although the trouble lies at the hip, The thigh rolls inwards, with the knee crossing the midline, A normal gait, since walking is unaffected, A line along the upper edge of the neck passes above the head, The first film was taken before any slip had occurred, A muscle tear from running, which came on over several hours, Nothing further at all, since the orthopaedic diagnosis has already been made, Kidney disease, which weakens the plate through disordered bone, The angle of the slip measured on the lateral radiograph, Manipulation of the hip now, under sedation in the department, Traction on the leg for six weeks, followed by gradual mobilisation at home, Forcing the head back into place, which strips the remaining vessels, An infection of the metalwork, which usually presents this late.

Clinical pearls from this deck

• The slipping plate belongs to the heavy adolescent.
• A normal knee with knee pain: examine the hip.
• Flex the hip: if the thigh rolls out, the plate has gone.
• Short leg, foot turned out: look at the growth plate.
• The neck line should clip the head; a slip misses it.
• Always ask for the lateral: a slip hides on the front view.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and orthopaedics case decks · pediatric reference values.