Radiographic evaluation in epiphysiolysis: possible predictors of bilaterality?
OBJECTIVE
To identify anatomical changes and skeletal maturity through radiographic analysis, allowing more accuracy for indication of surgical management of non-slipped hips in patients with epiphysiolisys.


METHODS
A retrospective study of the radiographs of 61 patients followed until the end of skeletal growth, assigned to two groups: 37 patients with unilateral epiphysiolysis, and 24 patients with contralateral epiphysiolysis diagnosed during follow-up. The skeletal maturity was evaluated using pelvis radiographs (Oxford method) and compared between the groups for patients of the same gender. In addition, the Southwick angle (in anteroposterior and in Lauenstein view), physeal sloping angle and physeal posterior sloping angle were compared as well.


RESULTS
Skeletal maturity showed a statistically significant difference between the two groups for both genders. It was observed that the lateral view of the Southwick angle is mathematically equal to the physeal posterior sloping angle, and were the only ones to show relevant differences between the groups.


CONCLUSIONS
The Oxford method and the Southwick angle in Lauenstein view can be utilized as parameters to help the physician to better indicate the prophylactic surgical treatment of the contralateral hip, in patients with slipped capital femoral epiphysis (SCFE). Level of Evidence III, Diagnostic Study.
Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo, SP, Brazil.
Marcos Barbieri
MB
Mestriner
Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo, SP, Brazil.
Cleber Marcial Aguilar
CM
Verquietini
Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo, SP, Brazil.
Gilberto
G
Waisberg
Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo, SP, Brazil.
Miguel
M
Akkari
Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo, SP, Brazil.
Erika Tiemi
ET
Fukunaga
Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo, SP, Brazil.
Cláudio
C
Santili
Adolescent; Age determination by skeleton; Child; Epiphyses, slipped; Female; Femur head; Hip joint/radiography; Humans; Male