Orthopaedics: SCFE: practice question

A Pediatrics 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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Pediatrics · Orthopaedics: SCFE

Sample item

An obese 13-year-old boy has knee pain and a limp with limited internal rotation of the hip. A frog-leg lateral X-ray shows posterior and inferior displacement of the femoral head. What is the diagnosis and management?

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

The answer and the reasoning

A. Slipped capital femoral epiphysis; non-weight bearing and in-situ pinning

SCFE is displacement of the capital femoral epiphysis through the physis, often presenting with knee pain. The ice-cream falling off the cone appearance is described on X-ray. Treatment is surgical fixation with a single screw to prevent further slip and avascular necrosis.

Option by option

  • A. Slipped capital femoral epiphysis; non-weight bearing and in-situ pinning (correct)

    Correct. SCFE needs in-situ pinning.

  • B. Perthes disease; observation

    Perthes occurs at a younger age.

  • C. Transient synovitis; rest

    Transient synovitis occurs in younger children and is self-limiting.

  • D. Septic arthritis; antibiotics

    Septic arthritis has fever and raised inflammatory markers.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Slipped capital femoral epiphysis; non-weight bearing and in-situ pinning. SCFE is displacement of the capital femoral epiphysis through the physis, often presenting with knee pain.

Why is "Perthes disease; observation" not the answer?

Perthes occurs at a younger age.

Why is "Transient synovitis; rest" not the answer?

Transient synovitis occurs in younger children and is self-limiting.

Why is "Septic arthritis; antibiotics" not the answer?

Septic arthritis has fever and raised inflammatory markers.

What concept does this question test?

It tests Orthopaedics: SCFE in Pediatrics. The ice-cream falling off the cone appearance is described on X-ray. Treatment is surgical fixation with a single screw to prevent further slip and avascular necrosis.

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 Orthopaedics: SCFE?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.