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Year: 2008 Volume: 28 Issue: 2

Year: 2007 Volume: 27

Correlation of radiographic changes with disease severity and demographic variables in children with stable slipped capital femoral epiphysis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Loder, Randall T.
Description	Country affiliation: United States Author Affiliation: Loder RT ( Department of Orthopaedic Surgery, Indiana School of Medicine, Indiana University, and the James Whitcomb Riley Children's Hospital, Indianapolis, IN 46202, USA. rloder@iupui.edu)
Abstract	The duration of symptoms in children with stable slipped capital femoral epiphysis (SCFE) varies widely, and radiographic metaphyseal changes develop at some point. It was the purpose of this study to investigate if metaphyseal changes correlate with symptom duration and other demographic parameters. A retrospective review of 97 children with idiopathic stable SCFE between 1998 and 2005 was performed. The child's sex, age, weight, height, body mass index (BMI) at diagnosis, and symptom duration were recorded. Anteroposterior and frog-lateral radiographs were reviewed to measure SCFE severity, the occurrence of adaptive changes, and the status of Klein line. Standard bivariate and logistic regression statistical analyses were used. A P < 0.05 was considered statistically significant. The average age was 12.4 +/- 1.7 years, symptom duration, 5.7 +/- 5.9 months; BMI, 28.3 +/- 4.3 kg/m; and SCFE angle, 28 degrees +/- 18 degrees. There was a correlation between SCFE severity and symptom duration (P = 0.002) but significant variability (r = 0.09). Metaphyseal changes were seen superiorly in 76%, inferiorly in 56%, anteriorly in 80%, and posteriorly in 84%. Symptom duration was not predictive of an abnormal Klein line. Those with more metaphyseal changer were older, had a longer duration of symptoms, had higher BMI, and had more severe SCFEs. Although SCFE severity generally increased with longer symptoms, some had prolonged symptoms with a mild SCFE, whereas others had short symptoms with a severe SCFE; perhaps the SCFE remains silent for varying periods of time before symptoms occur. Those children with more metaphyseal changes had higher BMIs; perhaps the larger body mass per unit of height translates into more bony adaptation following Wolf law.
File Format	HTM / HTML
ISSN	02716798
Issue Number	3
Volume Number	28
e-ISSN	15392570
Journal	Journal of Pediatric Orthopaedics
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-04-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Orthopedics Epiphyses, Slipped Femur Adolescent Age Factors Body Mass Index Child Epidemiology Female Humans Logistic Models Male Radiography Retrospective Studies Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Pediatrics, Perinatology and Child Health

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