Paediatric: slipped capital femoral epiphysis: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric: slipped capital femoral epiphysis

Sample item

An obese 13-year-old boy has knee pain and limp. On flexing the hip, the thigh rotates externally and cannot be flexed straight. Which sign is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Drehmann sign in slipped capital femoral epiphysis

In SCFE, the epiphysis slips posteriorly and inferiorly relative to the neck, and passive flexion of the hip causes obligatory external rotation (Drehmann sign). Knee pain is referred from the hip via the obturator nerve, and the Klein line fails to intersect the epiphysis.

Option by option

  • A. Galeazzi sign in DDH

    Galeazzi sign is apparent leg shortening in DDH.

  • B. Thomas test sign in hip contracture

    The Thomas test detects fixed flexion deformity.

  • C. Trendelenburg sign in Perthes disease

    Trendelenburg sign reflects abductor weakness and is not the described sign.

  • D. Drehmann sign in slipped capital femoral epiphysis (correct)

    Correct. Obligatory external rotation on flexion is the Drehmann sign.

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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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Drehmann sign in slipped capital femoral epiphysis. In SCFE, the epiphysis slips posteriorly and inferiorly relative to the neck, and passive flexion of the hip causes obligatory external rotation (Drehmann sign).

Why is "Galeazzi sign in DDH" not the answer?

Galeazzi sign is apparent leg shortening in DDH.

Why is "Thomas test sign in hip contracture" not the answer?

The Thomas test detects fixed flexion deformity.

Why is "Trendelenburg sign in Perthes disease" not the answer?

Trendelenburg sign reflects abductor weakness and is not the described sign.

What concept does this question test?

It tests Paediatric: slipped capital femoral epiphysis in Orthopaedics. Knee pain is referred from the hip via the obturator nerve, and the Klein line fails to intersect the epiphysis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric: slipped capital femoral epiphysis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.