What is the recommended workup for suspected slipped capital femoral epiphysis?

The recommended workup for suspected slipped capital femoral epiphysis (SCFE) involves obtaining lateral hip X-rays and lateral frog pelvis X-rays. This imaging strategy is essential because SCFE typically presents with specific radiographic signs. The lateral view of the hip is particularly helpful in visualizing the relationship between the femoral head and the femoral neck, as it can reveal any displacement of the epiphysis. The frog leg position allows for better visualization of the hip joint and can help in assessing the displacement more accurately, providing a clearer picture of the condition.

Using this combination of images helps in not only confirming the presence of SCFE but also in determining the severity of the displacement which is crucial for management decisions. Early detection and accurate assessment through these X-rays can lead to timely intervention, reducing the risk of complications such as avascular necrosis.

Other imaging modalities like MRI and CT are not first-line for SCFE; MRI can be useful in certain cases, particularly if there is a need to assess for associated conditions or if the radiographic findings are inconclusive, but it is not necessary for the initial workup. Similarly, while CT scans offer detailed images of bone structures, they are more invasive and not routinely used in the initial assessment