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Anatomy · Histology: growth plate
Sample itemAn obese 12-year-old boy has hip pain and a limp, and a radiograph shows the femoral epiphysis displaced posteriorly and inferiorly on the neck (slipped capital femoral epiphysis). Through which zone of the growth plate does the slip typically occur?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Zone of hypertrophic cartilage
The hypertrophic zone has swollen chondrocytes and little matrix, so it is the mechanically weakest layer of the physis and the site of slippage. Shear forces from obesity and a growth spurt exceed its strength. The slip is then treated by in-situ pinning.
Option by option
A. Proliferative (columnar) zone
The proliferative zone is where chondrocytes divide into columns, and impaired proliferation here underlies achondroplasia.
B. Zone of primary spongiosa
The primary spongiosa is metaphyseal bone laid on calcified cartilage and is a typical site for haematogenous osteomyelitis.
C. Zone of hypertrophic cartilage (correct)
Correct. The hypertrophic zone is the weak layer where shear causes the epiphysis to slip.
D. Reserve (resting) zone
The resting zone anchors the epiphysis and supplies progenitor cells but is not the plane of failure.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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