Paediatric orthopaedics: Klein line in SCFE: practice question

A Orthopaedics 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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Orthopaedics · Paediatric orthopaedics: Klein line in SCFE

Sample item

A 12-year-old obese boy has groin and knee pain. On an AP pelvis radiograph, a line drawn along the superior border of the femoral neck normally cuts across part of the femoral epiphysis, but fails to do so on the painful side. Which line is this?

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

The answer and the reasoning

B. Klein line

Klein's line, drawn along the superior border of the femoral neck, should intersect the lateral part of the epiphysis. When the epiphysis slips posteriorly and inferiorly the line misses it, indicating a slipped capital femoral epiphysis, and the finding is often called Trethowan sign.

Option by option

  • A. Hilgenreiner line

    Hilgenreiner line is the horizontal line through the triradiate cartilages.

  • B. Klein line (correct)

    Correct. Failure of the superior neck line to cut the epiphysis suggests a slip.

  • C. Perkin line

    Perkin line is the vertical line from the lateral acetabular margin used in DDH.

  • D. Shenton line

    Shenton line is the smooth arc of the femoral neck and the superior pubic ramus.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Klein line. Klein's line, drawn along the superior border of the femoral neck, should intersect the lateral part of the epiphysis.

Why is "Hilgenreiner line" not the answer?

Hilgenreiner line is the horizontal line through the triradiate cartilages.

Why is "Perkin line" not the answer?

Perkin line is the vertical line from the lateral acetabular margin used in DDH.

Why is "Shenton line" not the answer?

Shenton line is the smooth arc of the femoral neck and the superior pubic ramus.

What concept does this question test?

It tests Paediatric orthopaedics: Klein line in SCFE in Orthopaedics. When the epiphysis slips posteriorly and inferiorly the line misses it, indicating a slipped capital femoral epiphysis, and the finding is often called Trethowan sign.

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 Paediatric orthopaedics: Klein line in SCFE?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.