Trethowan's sign

Trethowan's Sign

Trethowan's sign as seen in SCFE

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

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

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

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

• Slipped capital femoral epiphysis
• Hip joint
• Avascular necrosis
• Radiograph