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Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis (SCFE) is a developmental condition of the hip that affects adolescents. The upper-end of the thigh bone (femur) is a round “ball” shape that joins the socket of the pelvis to form the hip joint. A SCFE occurs when there is a weakening in the femur growth plate, causing the ball to slip off the neck on the upper thigh bone. Most of the time, this happens slowly and gradually, though it can occur from a trauma or fall. This condition affects overweight males more often than females and usually occurs during a period of rapid growth in puberty.

Children present with gradual hip or thigh pain and may limp while walking. The affected extremity may be shorter than the other and the foot can turn outward. Sometimes, he or she will have knee pain or will be unable to bear weight on the extremity due to pain.

To diagnose a SCFE, your doctor will assess gait pattern and range of motion at the hip. Most patients have pain during movement at the hip joint. X-rays will confirm the diagnosis by showing growth plate slippage in the hip.

If this condition is not treated, early arthritis in the hip can develop. The unstable femoral head can disrupt blood supply to the bone and cause avascular necrosis (bone collapse). Surgery aims to prevent further femoral head slippage until the growth plate closes. To do so, the surgeon will insert screws across the growth plate in the femur to keep the femoral head stable.

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