How do you rule out a slipped capital femoral epiphysis?

SCFE is diagnosed through physical exam including rotation of the affected leg, observation while walking and X-rays. A MRI may be ordered if the diagnosis is not able to be made with X-rays and your healthcare provider still suspects your child has SCFE.

What are the symptoms of slipped capital femoral epiphysis?

Symptoms of SCFE typically include complaints of pain in the groin or hip that is aggravated by activity. Sometimes the child will also experience pain in the thigh or knee area. In acute or unstable slips, the child will complain of immediate pain, limp, or feel like the leg is “giving way.”

What is SCFE in hip?

Slipped capital femoral epiphysis (SCFE) a disorder of adolescents in which the growth plate is damaged and the femoral head moves (“slips”) with respect to the rest of the femur. The head of the femur stays in the cup of the hip joint while the rest of the femur is shifted.

Which of the following is the most typical presenting symptom of slipped capital femoral epiphysis SCFE )?

The most common symptoms of SCFE are limping and pain that is poorly localized to the hip, groin, thigh, or knee. Knee or distal thigh pain is the presenting symptom in 15% of patients with this condition.

Is slipped capital femoral epiphysis a disability?

SCFE occurs through the unfused growth plate of the proximal femur where the femoral head slips posteriorly on the femoral neck. Serious consequences of the problem, such as gait disturbance, post-traumatic arthritis, chondrolysis and osteonecrosis of the femoral head can occur, leading to lifelong disability.

Why is SCFE an emergency?

Treating SCFE is considered urgent because further slipping could damage the hip joint. To prevent further slipping, the child may be admitted to the hospital right away for surgery. Or the child may be instructed to use crutches and not put any weight on the leg until the SCFE can be repaired.

What does a slipped hip feel like?

Mild pain in the hips, groin or around the knees. Severe pain that makes children stop putting weight on the leg that hurts. Stiffness in the hip. Less movement than usual in the hip.

Is SCFE an emergency?

SCFE is usually an emergency and must be diagnosed and treated early. In 20 to 40 percent of affected children, SCFE will be present in both hips at the time the child is diagnosed. If only one hip is affected, the other hip will eventually slip 30 to 60 percent of the time. Treatment is surgical.

Can SCFE happen again?

In SCFE, the “ball” (called the epiphysis) slips off of the top part of the femur, almost the way a scoop of ice cream might slip off a cone. Sometimes this happens suddenly — after a fall or sports injury, for example. But it can also happen gradually, with no previous injury.

Is SCFE considered a fracture?

A SCFE is actually a fracture of the growth plate. The fracture is usually a fairly stable one, and the slippage occurs very slowly.

What is hip instability?

Hip instability is a loose or wobbly hip joint that’s usually caused by problems with the ligaments (the bands of connective tissue that hold bones or joints together). In hip dislocation, the ball at the end of the thighbone is pushed out of the socket.

What does SCFE look like on xray?

Typical radiographic signs of SCFE: (a) widening with irregularities of the physis, (b) loss of concavity of the anterior femoral head-neck junction and (c) reduced height of the epiphysis compared with the contralateral, unaffected hip.

Can SCFE cause hip impingement?

SCFE may also cause impingement within the hip joint, sometimes due to the placement of the screw used to stabilize the SCFE. Additionally, femoroacetabular impingement (FAI) may occur as a result of changes to the shape of the femur and/or socket.

What is the difference between unstable and unstable slip and SCFE?

Unstable SCFE requires urgent treatment. Complications associated with SCFE are much more common in patients with unstable slips. SCFE usually occurs on only one side; however, it can occur on the opposite side, as well. If so, this happens within 18 months from the time of the initial episode. The cause of SCFE is not known.

What happens if you have SCFE in your femur?

In severe cases, SCFE may interrupt the blood supply to the femoral head. This can lead to a gradual and very painful collapse of the bone — a condition called avascular necrosis (AVN) or osteonecrosis. When the bone collapses, the articular cartilage covering the bone also collapses.

How do you know if you have SCFE in your hip?

Your doctor will order x-rays of the pelvis, hip, and thigh from several different angles to help confirm the diagnosis. In a patient with SCFE, an x-ray will show that the head of the thighbone appears to be slipping off the neck of the bone. X-ray of a 12-year-old boy with stable SCFE in his left hip (arrow).