Slipped Capital Femoral Epiphysis

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Slipped Capital Femoral Epiphysis (SCFE) is an unusual disorder of the adolescent hip. It is not rare. For reasons that are not well understood, the ball at the upper end of the thigh bone slips off in a backward direction. This is due to weakness of the growth plate. Most often, it develops during periods of accelerated growth, shortly after the onset of puberty.

SCFE has three degrees of severity:

  • mild - approximately one-third of the femoral head slips off of the thigh bone
  • moderate - approximately one-third to one-half of the femoral head slips off of the thigh bone
  • severe - more than one-half of the femoral head slips off of the thigh bone

  • Symptoms:
      Symptoms of SCFE typically include complaints of pain in the hip that is aggravated by activity. Sometimes the child will also experience pain in the groin, thigh, or knee area.
      In acute slips, the child will complain of immediate pain, limp, or feel like the "leg is giving way."
      The child with a chronic slip usually walks with a limp, complains of hip pain, and reports that rest alleviates the pain. The child may also walk with his/her leg turned outward.
      The symptoms of SCFE may resemble other conditions or medical problems of the hip. Always consult your child's physician for a diagnosis.
    The cause of slipped capital femoral epiphysis is unknown. Risk factors that increase the likelihood of SCFE include the following:

    Risk factors may include:

  • medications (such as steroids)
  • thyroid problems
  • radiation treatment
  • chemotherapy
  • bone problems related to kidney disease

  • Treatment:
    Specific treatment for SCFE will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • the extent of the condition
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

  • The goal of treatment is to prevent the femoral head from further slippage. Treatment usually may include:

  • surgery involving the use of a steel pin to hold the femoral head onto the femur to prevent it from slipping further
  • physical therapy (following surgery, to help strengthen the hip and leg muscles)

  • Long-term outlook:
    The more severe the case, the greater the likelihood the child will experience limited hip motion, differences in leg lengths, and further hip problems in adulthood. However, with early detection and proper treatment, a good outcome with few problems is possible.

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