Point-of-care Ultrasound Diagnosis of Slipped Capital Femoral Epiphysis

Abstract

An 11-year-old female was brought to the emergency department with left hip and knee pain as well as limping for three weeks. There was no fever or recent trauma. Physical examination revealed restricted range of movement due to pain on hip flexion, internal and external rotation. A point-of-care ultrasound (POCUS) performed by an emergency physician (Image 1) raised the suspicion for her diagnosis when compared with right side (Image Image 1. Point-of-care ultrasound image of left hip showing displacement of epiphysis(e) from metaphysis (m) – the physeal step (arrow). 2), which prompted expedited immobilization and pain control. POCUS was performed using a linear, high- frequency probe (14-5 MegaHertz) aligned parallel to the femoral neck. Subsequently, her pelvic radiograph (Image 3) confirmed the diagnosis.