MSK imaging: SCFE: practice question

A Radiology 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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Radiology · MSK imaging: SCFE

Sample item

An obese 13-year-old boy has knee pain and limited hip internal rotation. A frog-leg lateral view shows posterior and inferior displacement of the femoral epiphysis. Which sign is seen on the AP view?

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

The answer and the reasoning

A. Klein line fails to intersect the epiphysis (ice cream slipping off the cone)

In slipped capital femoral epiphysis, a line drawn along the superior femoral neck (Klein line) does not pass through the epiphysis, and the physis looks widened. The slip is posteromedial. Treatment is surgical pinning in situ.

Option by option

  • A. Klein line fails to intersect the epiphysis (ice cream slipping off the cone) (correct)

    Correct. Klein line missing the epiphysis indicates a slip.

  • B. Shenton line is normal and unbroken always

    Shenton line may be disturbed in advanced slips and in DDH.

  • C. Crescent sign

    The crescent sign is seen in avascular necrosis.

  • D. Wimberger sign

    Wimberger sign is seen in scurvy and syphilis.

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 Radiology question

What is the answer to this Radiology question?

The best answer is A, Klein line fails to intersect the epiphysis (ice cream slipping off the cone). In slipped capital femoral epiphysis, a line drawn along the superior femoral neck (Klein line) does not pass through the epiphysis, and the physis looks widened.

Why is "Shenton line is normal and unbroken always" not the answer?

Shenton line may be disturbed in advanced slips and in DDH.

Why is "Crescent sign" not the answer?

The crescent sign is seen in avascular necrosis.

Why is "Wimberger sign" not the answer?

Wimberger sign is seen in scurvy and syphilis.

What concept does this question test?

It tests MSK imaging: SCFE in Radiology. The slip is posteromedial. Treatment is surgical pinning in situ.

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 MSK imaging: SCFE?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.