Curriculum · Musculoskeletal / Orthopedic / Rheumatology
Slipped capital femoral epiphysis
What it is
Slipped capital femoral epiphysis is a displacement of the femoral head epiphysis postero-inferiorly. It is the most common hip disorder in adolescents, and it is listed among the paediatric hip conditions together with developmental dysplasia of the hip, transient synovitis, and Legg-Calve-Perthes disease. The age is adolescence, put at 8 to 15 years in one place and at 10 to 15 years in another.
Causes and risk
It is more common in obese children. In the past it was more common in boys than in girls, but that prevalence is changing with the rise in obesity. It is rarely associated with trauma, overuse, or prior illness. Treatment with growth hormone carries the risk of an increased incidence of it, especially in rapidly growing adolescents.
How it presents
It should be suspected in an adolescent who has unexplained pain in the hip, groin, medial thigh, or knee, and in one who presents with a new limp. The most indicative sign on examination is limited internal rotation of the involved hip, which is also put as loss of internal rotation of the leg in flexion. Weeks of groin pain that is worse after gym class at school, with no injury the adolescent can recall and a BMI at the 95th percentile, is the picture drawn for it.