Quantitative Evaluation of Hip Muscle Atrophy in Patients with Unilateral Slipped Capital Femoral Epiphysis Based on Magnetic Resonance Imaging

Novelties in slipped capital femoral epiphysis imaging: A narrative review

Rationale and objectives

Imaging plays a key role in Slipped Capital Femoral Epiphysis diagnosis and severity assessment. In the last two decades, signs and measurements emerged in literature showed potential to help in SCFE diagnosis and tailoring treatment. The purpose of this review is to collect and discuss new imaging signs, measurements, and techniques according to investigations published after 2000 to improve SCFE diagnosis.

Material and methods

The PubMed, Scopus, and Science Direct databases were used to search for relevant articles related to imaging in SCFE diagnosis from January 2000 to March 2023. Article selection and review was performed by two board-certified radiologists). Article quality assessment were conducted by authors using QUADAS-2 and SANRA evaluation tools.

Results

The research resulted in a total of 2577 articles. After duplicates removal and abstract analysis, 28 articles were finally selected for full-text analysis. Seventeen articles were focused on Radiographs, 6 on CT, 1 on both Radiographs and CT, 4 on MRI. No study focused on ultrasound was selected.

Conclusions

Use of modified Klein's line and S-sign may improve radiographs accuracy in daily routine. Lucency sign may help in early diagnosis on radiographs. Preoperative CT may be useful in planning a tailored treatment predicting SCFE severity and instability. MRI is the most accurate modality to diagnose SCFE at early stage. Nevertheless, it cannot be used to predict the risk of contralateral SCFE. Risk prediction can be assessed with radiographs, using a new rapid mOBS. Further investigation and validation of these sign is needed.

ETIOLOGY, PATHOGENESIS, DIAGNOSIS AND PRINCIPLES OF TREATMENT OF SLIPPED CAPITAL FEMORAL EPIPHYSIS. LITERATURE REVIEW

Aim: to describe the epidemiology, possible causes and predisposing factors for the development of slipped capital femoral epiphysis. To follow the evo­lution of classifications. Analyze indications for surgical treatment, as well as types of surgical treatment.  

Materials and methods: this review article analyzes the data of Russian and foreign literature on the etiology, pathogenesis, diagnosis and treatment of slipped capital femoral epiphysis.  

Results: in view of the frequent distribution in the population, high risks of disability in pediatric patients, the issue of treatment of slipped capital femoral epiphysis remains very relevant. Many methods of surgical treatment have been proposed depending on the stage of the disease, however, they have their own advantages and disadvantages.  

Conclusions: Conservative treatment in the long term did not show good results, generally accepted, according to most sources of literature, surgical treatment is considered. The gold standard in the surgical treatment of the disease does not exist today, and the methods and tactics of treatment are being improved.