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ANSWER
The correct answer is aseptic necrosis of the capital femoral
epiphysis in early Perthe's disease. This process is evidenced
by the subarticular radiolucent crescent (arrow), which warns
of incipient collapse of the epiphysis due to its loss of
blood supply.
For further reading, see F.N. Silverman and J. Kuhn,
Caffey's Pediatric X-Ray Diagnosis, 9th ed., St. Louis,
Mosby-Year Book, 1993, p. 1821.
Emerg Med 34(8):61, 2002
This series of diagnostic quizzes
that challenge your ability to read a variety of x-ray films
is edited by Dr. Keats, professor of radiology and professor
of orthopedics at the University of Virginia School of Medicine
in Charlottesville.
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