Slipped capital femoral epiphysis (SCFE) is a condition in which the ball of the femur (femoral head) slips slightly off the femur or thighbone. SCFE can occur due to injury, or it can develop slowly over time.
SCFE can develop during time of rapid growth, which occurs shortly after the onset of puberty. Boys are more likely than girls to have SCFE. Being obese is also a contributing factor. Sometimes, a problem with the hormones in the body can contribute to the development of SCFE. If your child is diagnosed with slipped capital femoral epiphysis, his or her orthopedic surgeon will let you know if there is a need to refer your child to a pediatric endocrinologist.
Signs and symptoms of slipped capital femoral epiphysis include a history of knee or hip pain for several weeks or months and an occasional limp. Sometimes, the SCFE is severe, and your child will not be able to walk on the affected leg.
Doctors at Riley at IU Health diagnose SCFE through a physical exam and X-ray imaging. On physical exam, your child may have pain when the orthopedic surgeon moves his or her hip in certain directions. The orthopedic surgeon will watch your child walk (if he or she is able) in order to check for abnormal gait.
X-rays of the pelvis will be done to show the position of the femoral head in relation to the rest of the femur (thighbone). The orthopedic surgeon will look for slight slipping of the femoral head. The best way to explain this is to picture a scoop of ice cream slipping off a cone—the amount of slipping can vary. Sometimes, a magnetic resonance imaging (MRI) scan is ordered to further evaluate the hip.
Surgery is needed to treat SCFE. Your child’s orthopedic surgeon will discuss the surgery with you. Surgery for SCFE is done within a couple days of diagnosis, depending on the severity of the slip.
It is very important to follow the postoperative instructions. Your child will have specific weight-bearing and activity restrictions for a period of time, including no sports. Following these instructions will help minimize the chance of further complications.
Your child will have frequent follow-up appointments (including X-rays) to make sure the hip is healing appropriately and to monitor for avascular necrosis. Avascular necrosis in SCFE means that the slipping of the femoral head has decreased blood supply to the ball of the femur.
There is no way to identify or prevent this complication before it happens. It is very important not to miss your child’s orthopedic surgery follow-up appointments so that the surgeon can evaluate the femoral head and make sure it does not develop avascular necrosis.
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