Slipped Upper Femoral Epiphysis: Free MSRA Podcast

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Slipped Upper Femoral Epiphysis: Free MSRA Podcast

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⚕️ FREE MSRA PODCAST – Slipped Upper Femoral Epiphysis (SUFE)🎧 A rapid yet thorough breakdown of SUFE — an essential orthopaedic emergency in paediatrics and MSRA prep. Learn to spot it early, manage it correctly, and prevent serious long-term complications.🧠 Key Learning Points📌 Definition• SUFE = Slippage of the femoral head at the growth plate (physis)• Most common in adolescents (10–15 years) during growth spurts• Posteroinferior displacement of the femoral head relative to the neck💡 Mnemonic: “Slipping teens need urgent screening”📌 Classification Summary👣 By Onset:• Pre-slip (early/subtle), Acute, Chronic, Acute-on-chronic🧍 By Stability:• Stable = weight-bearing possible → better prognosis• Unstable = non-weight-bearing → high AVN risk📏 By Severity (Radiology):• Grade 1 (mild), Grade 2 (moderate), Grade 3 (severe)📌 Pathophysiology• Weak growth plate + shear stress → slippage• Blood supply at risk → potential avascular necrosis (AVN)• Obesity is a major risk due to increased mechanical load💡 Mnemonic: “ABODI-MATES”Adolescents, Boys, Obesity, Dysplasia, Inflammation, Mechanical stress, Affected family, Treatment (chemo/radio), Endocrine (e.g. hypothyroid), Septic arthritis history📌 Differential Diagnoses• Septic arthritis• Transient synovitis• Perthes disease• JIA• DDH• Hip fracture• Osteomyelitis📌 Epidemiology• UK incidence ~1 in 50,000• More common in boys, peak age 8–15• Bilateral in 20–80%• Incidence rising with childhood obesity📌 Clinical Features• Hip, thigh, groin or referred knee pain• Limp or antalgic gait• ↓ Internal rotation; external rotation on hip flexion• Leg shortening, thigh wasting• Inability to weight-bear = red flag for unstable SUFE💡 Tip: “Teen with knee pain? Always examine the hip.”📌 Investigations• X-ray: AP + frog-leg lateral = diagnostic – Posteroinferior displacement of epiphysis – Klein’s line fails to intersect epiphysis• MRI/CT: For complex or subtle cases• Bloods: ESR/CRP to rule out septic causes• Ultrasound: May show effusion (not diagnostic)📌 Management🚨 Emergency referral to orthopaedics🦽 Non-weight-bearing immediately🔩 Surgical fixation:• In-situ screw fixation (stable)• Open reduction or osteotomy (unstable/severe)🚫 Avoid manipulation → risk of AVN🧘‍♂️ Physio starts post-op; not part of initial treatment📌 Complications• Avascular necrosis (AVN)• Chondrolysis• Femoroacetabular impingement (FAI)• Early osteoarthritis• Limb-length discrepancy• Recurrent or bilateral SUFE📌 Prognosis• ✅ Good if diagnosed early and stable• ⚠️ Worse with unstable, delayed, or severe slips• Early surgical intervention = key to prevent AVN and OA📚 MSRA Revision Links – SUFE📝 Revision Notes🧠 Flashcards📖 Accordion Q&A🎯 Rapid Quiz🧪 Quiz Access🌐 More MSRA Supportwww.PassTheMSRA.comwww.FreeMSRA.com💬 Final ThoughtTeenagers don’t just get growing pains. SUFE can hide in plain sight — especially as “knee pain.” Spot it early, get an X-ray, refer urgently. That’s how you save a joint and avoid lifelong disability.#MSRA #SlippedUpperFemoralEpiphysis #SUFE #MSRARevision #MSRAQuiz #MSRAFlashcards #Paediatrics #HipPain #KneePain #FemoralEpiphysis #PassTheMSRA #FreeMSRA #Orthopaedics #GrowthPlateDisorders #MSK #MultispecialtyRecruitmentAssessment