Review the Learning Outcomes, Hx, PE and Labs, and begin the module with your Provisional Diagnosis. Keep hitting "Next" to move through the module.
- Articulate your relationship with the consulting diagnostic radiologists in the evaluation of a pediatric patient with difficulty ambulating.
- Review the DDx considerations in a pediatric patient with difficulty ambulating.
- Identify the spectrum of imaging findings in appropriate modalities for evaluating a pediatric patient with difficulty ambulating.
What is your assessment of the likely acuity for this patient?
First Imaging Study
What is the first imaging study you will order?
Pertinent Imaging Observations
Click on the links below to view images from the study, and assess these key findings as best you can.
AP and frog-leg Pelvis XR
What best describes the findings on the AP and frog-leg Pelvis XRs? (check all that apply)
Watch our video
Second Imaging Study
What is the next imaging study you will order?
What is your Diagnosis now that you have seen the imaging results?
Initially, you selected and we suggested acuity.
Has your concern for this patient changed?
Assessment and Plan
Please provide your assessment and plan for this patient
- SCFE is more likely to occur in males than females
- SCFE is more likely to occur in obese children with endocrine abnormalities such as hypothyroidism, pituitary tumors, and low testosterone.
- The diagnosis should be suspected in children 10-16.
- The first best diagnostic modality is an AP Pelvic XR and Frog Leg Lateral XR. The epiphysis will look like a scoop of ice cream that has fallen off its cone.
Socioeconomic Factors: Time to diagnosis and slip angles are positively correlated, and patients without insurance have a higher mean slip angles than patients with insurance.
That's the end of the module! Once you've reviewed the video(s), you can click here for another case challenge.
Jacob Surges, MS3 - Content Contributor
Kevin Pierre, MD - Editor
Robbie Slater, MD - Supervising Editor
Bayar Batmunh, MS - Coordinator