Alshryda Sattar, Alfuqaha Haidar, Elgabaly Elham A, Aldlyami Ehab
Pediatric Orthopaedics and Trauma, Al Jalila Children's Speciality Hospital, Dubai, ARE.
Pediatric Orthopaedics, Alkhalidi Hospital, Amman, JOR.
Cureus. 2020 Feb 4;12(2):e6867. doi: 10.7759/cureus.6867.
Avascular necrosis (AVN) of the femoral head following slipped capital femoral epiphysis (SCFE) is a serious complication that often leads to a permanent disability. Radiological findings of AVN may take up to two years to become apparent. This means painful waiting for children, parents, and treating teams. We would like to describe a new radiological sign that we noted in four patients. The sign has been named as the crescent moon sign or eid crescent sign. It may become visible as early as six weeks following surgery, and it carries a good prognosis that the femoral head is viable and will not develop AVN. Two out of the four patients were treated in our hospital by Ganz surgical dislocation. The other two patients had been featured in other publications, but the significance of the moon crescent signs, which were present, was not recognized or appreciated. All four patients did not develop AVN. A relatively similar radiological sign has been described in talus bone fractures (Hawkins' sign). Like SCFE, talus bone fractures have a high AVN rate. Both, the crescent moon sign and Hawkins' sign carry a good prognosis and indicate that the bone blood supply is restored.
股骨头骨骺滑脱（SCFE）后发生的股骨头缺血性坏死（AVN）是一种严重并发症，常导致永久性残疾。AVN的影像学表现可能需要长达两年时间才会显现出来。这意味着患儿、家长以及治疗团队需要漫长而痛苦的等待。我们想要描述一种我们在四名患者身上发现的新的影像学征象。该征象被命名为新月征或开斋节新月征。它最早在术后六周即可显现，提示股骨头血运良好、不会发生AVN。四名患者中有两名在我院接受了Ganz手术脱位治疗。另外两名患者曾在其他文献中被报道，但当时存在的新月征的意义未被认识或重视。所有四名患者均未发生AVN。距骨骨折中也描述过一种相对类似的影像学征象（霍金斯征）。与SCFE一样，距骨骨折发生AVN的几率很高。新月征和霍金斯征均提示预后良好，表明骨血供已恢复。
