Slipped capital femoral epiphysis
| Slipped capital femoral epiphysis | |
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| X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation. | |
| Classification and external resources | |
| DiseasesDB | 12185 |
| MedlinePlus | 000972 |
| eMedicine | article/413810 |
Slipped capital femoral epiphysis (SCFE or skiffy, slipped upper femoral epiphysis, SUFE or souffy, coxa vara adolescentium) is a medical term referring to a fracture through the growth plate (physis), which results in slippage of the overlying end of the femur (epiphysis). Normally, the head of the femur, called the capital, should sit squarely on the femoral neck. Abnormal movement along the growth plate results in the slip. The femoral epiphysis remains in the acetabulum (hip socket), while the metaphysis (end of the femur) move in an anterior direction with external rotation.
SCFE is the most common hip disorder in adolescence. SCFEs usually cause groin pain on the affected side, but sometimes cause knee or thigh pain. One in five cases involve both hips, resulting in pain on both sides of the body. SCFEs often occur in obese adolescent males, especially young Black males, although it also affects females. Symptoms include the gradual, progressive onset of thigh or knee pain with a painful limp. Hip motion will be limited, particularly internal rotation. Running and other strenuous activity on legs will also cause the hips to abnormally move due to the condition and can potentially worsen the pain. Stretching is very limited.
Usually, a SCFE causes groin pain, but it may cause pain in only the thigh or knee, because the pain may be referred along the distribution of the obturator nerve. The pain may occur on both sides of the body (bilaterally), as up to 40 percent of cases involve slippage on both sides. After a first SCFE, when a second SCFE occurs on the other side, it typically happens within one year after the first SCFE. About 20 percent of all cases include a SCFE on both sides at the time of presentation.
Signs of a SCFE include a waddling gait, decreased range of motion. Often the range of motion in the hip is restricted in internal rotation, abduction, and flexion. A person with a SCFE may prefer to hold their hip in flexion and external rotation.
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