PMC9815491_01
AP pelvis (A) and frog legs lateral (B) X-ray.. Bilateral iliac crest as well as femoral metaphyseal irregularity (red arrows), likely related to the known renal disease. Visualized bones and joint spaces are unremarkable. No fracture or dislocation. No gross soft tissue abnormality.. AP, anteroposterior
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FIG1
Given the patient's age and lack of radiological findings on her anteroposterior (AP) pelvis and frog legs lateral X-ray report (Figure 1A,B), SCFE was deemed unlikely.
MRI pelvis body T1 (A) and T2 (B). . Symmetric bilateral capital femoral and greater trochanter physis signal intensities with no evident SCFE. However, mild diffuse increased T2 signal intensity of the left femoral head (red arrow) with normal height is seen, differentials may include subtle edema for early AVN.. SCFE, slipped capital femoral epiphyses; AVN, avascular necrosis
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FIG2
AP pelvis (A) and frog legs lateral (B) X-ray. . Redemonstration of bilateral physeal widening, proximal femoral metaphyseal, and iliac crests irregularities, most likely related to chronic kidney disease. On Figure 3B, there is bilateral posterior medial slippage of the femoral epiphysis (red arrows), the right worse than the left, finding are suggestive of bilateral SCFE, with no fractures or gross soft tissue abnormalities.. SCFE, slipped capital femoral epiphyses
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FIG3
However, her physical examination findings remain unchanged, but the AP pelvis and frog legs lateral X-ray report (Figure 3A,B) showed early slippage of right and left femoral heads.
AP pelvis (A) and frog legs lateral (B) X-ray. . Status post bilateral in situ pin fixation (red arrows).  No hardware complications.
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FIG4
Finally, a diagnosis of bilateral SCFE was made and the patient underwent bilateral in-situ fixation with an uneventful postoperative recovery (Figure 4A,B).