Trethowan's sign: Difference between revisions

Latest revision as of 16:33, 16 February 2025

Trethowan's Sign[edit]

Trethowan's sign is a clinical and radiological indicator used in the diagnosis of slipped capital femoral epiphysis (SCFE), a condition that affects the hip joint in adolescents. This sign is named after the British surgeon who first described it.

Clinical Presentation[edit]

Trethowan's sign is observed in patients who present with symptoms of SCFE, which typically include hip pain, limping, and restricted range of motion in the affected hip. The condition is more common in adolescents and is often associated with obesity and growth spurts.

Radiological Features[edit]

On an anteroposterior radiograph of the pelvis, Trethowan's sign is identified by drawing a line along the superior border of the femoral neck. In a normal hip, this line, known as Klein's line, should intersect the epiphysis of the femoral head. In SCFE, the epiphysis is displaced, and Klein's line does not intersect the epiphysis, indicating a slip.

Diagnosis and Management[edit]

The presence of Trethowan's sign on a radiograph is a key diagnostic feature of SCFE. Early diagnosis is crucial to prevent further slippage and complications such as avascular necrosis of the femoral head. Management typically involves surgical intervention to stabilize the epiphysis, often using screw fixation.

Related Pages[edit]

Template:Musculoskeletal system

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-'''Trethowan's sign''' is a clinical sign used in the diagnosis of [[slipped capital femoral epiphysis]] (SCFE), a common hip disorder in adolescents. The sign is named after British orthopedic surgeon, Sir [[Harry Platt]], who first described it in 1957.
+== Trethowan's Sign ==
-==Definition==
+[[File:Trethowan's_sign_seen_in_SCFE.jpg|thumb|right|Trethowan's sign as seen in SCFE]]
-Trethowan's sign is positive when there is limited internal rotation and pain on forced internal rotation of the hip. This is often associated with an outward turning (external rotation) of the leg. The sign is indicative of a slipped capital femoral epiphysis, a condition where the growth plate (epiphysis) at the top end of the thigh bone (femur) slips backwards and downwards.
-==Clinical Significance==
+'''Trethowan's sign''' is a clinical and radiological indicator used in the diagnosis of [[slipped capital femoral epiphysis]] (SCFE), a condition that affects the [[hip joint]] in adolescents. This sign is named after the British surgeon who first described it.
-The presence of Trethowan's sign is a significant finding in the clinical examination of a child or adolescent presenting with hip or knee pain. It aids in the early detection of SCFE, which is crucial as delayed diagnosis and treatment can lead to complications such as [[avascular necrosis]] of the femoral head, chondrolysis, and early onset [[osteoarthritis]].
-==Diagnosis==
+== Clinical Presentation ==
-The diagnosis of SCFE is confirmed by radiographic imaging, typically an anteroposterior and frog-leg lateral view of the hip. However, the presence of Trethowan's sign in the clinical examination can raise the suspicion of SCFE and prompt further investigation.
-==Treatment==
+Trethowan's sign is observed in patients who present with symptoms of SCFE, which typically include [[hip pain]], [[limping]], and restricted range of motion in the affected hip. The condition is more common in [[adolescents]] and is often associated with [[obesity]] and [[growth spurts]].
-The treatment of SCFE is primarily surgical, aiming to stabilize the slipped epiphysis and prevent further slippage. The choice of surgical procedure depends on the severity of the slip and the skeletal maturity of the patient.
-==See Also==
+== Radiological Features ==
-* [[Kocher's sign]]
-* [[Drehmann's sign]]
-* [[Hip disorders]]
-* [[Pediatric orthopedics]]
-==References==
+On an [[anteroposterior radiograph]] of the pelvis, Trethowan's sign is identified by drawing a line along the superior border of the [[femoral neck]]. In a normal hip, this line, known as [[Klein's line]], should intersect the [[epiphysis]] of the femoral head. In SCFE, the epiphysis is displaced, and Klein's line does not intersect the epiphysis, indicating a slip.
-* Platt, H., & Trethowan, W. (1957). Slipped upper femoral epiphysis. Journal of Bone and Joint Surgery, 39(4), 802-825.
-[[Category:Medical signs]]
+== Diagnosis and Management ==
-[[Category:Orthopedic clinical signs]]
-[[Category:Pediatrics]]
+The presence of Trethowan's sign on a radiograph is a key diagnostic feature of SCFE. Early diagnosis is crucial to prevent further slippage and complications such as [[avascular necrosis]] of the femoral head. Management typically involves surgical intervention to stabilize the epiphysis, often using [[screw fixation]].
-{{Medicine-stub}}
+== Related Pages ==
+* [[Slipped capital femoral epiphysis]]
+* [[Hip joint]]
+* [[Avascular necrosis]]
+* [[Radiograph]]
+{{Musculoskeletal system}}
+[[Category:Orthopedic signs]]
+[[Category:Radiologic signs]]