Slipped capital femoral epiphysis (SCFE) is the most common hip disorder in pre-teens and teenagers, usually affecting the hip joint in those between the ages of 10 and 16. It develops gradually over time, usually during the onset of puberty when there is a period of rapid growth.
This condition occurs when the neck of the thigh bone (femur) slips out of position at the level of the growth plate, in relation to the head. The growth plate, which is made up of cartilage, is a point of weakness. The resulting slippage affects the alignment of the bone, and hence the joint.
A patient may complain of pain in one hip with resultant difficulty in bearing weight on the lower limb of the affected side. A younger patient may experience the same problem in the opposite hip within 18 months. It is also more common in boys than girls, and can lead to complications in the hip joint if left untreated.
There are 2 classifications of slipped capital femoral epiphysis. Determining which classification someone has will allow their doctor to understand how urgent the management of the condition needs to take place:
Symptoms of SCFE vary widely, depending on its severity.
Symptoms of stable SCFE – Patients with stable SCFE typically experience milder symptoms of pain or stiffness in the groin, hip, knee or thigh. The pain will likely come and go for several weeks or months, and it may get worse with activity. However, the patient will still be able to bear weight on the affected side.
Symptoms of unstable SCFE – In severe or unstable SCFE, patients usually experience pain, which can start suddenly, especially after a fall or injury to the hip. Under these circumstances, patients will be unable to walk or place any weight on the affected side. There may also be visible signs such as a discrepancy in leg length or an outward turning (external rotation) of the affected leg.
Experts are unsure what causes slipped capital femoral epiphysis, though there are several known risk factors.
Slipped capital femoral epiphysis is more likely to occur during the growth spurt of puberty, and it is more likely to affect the left hip. It is also more common in boys than in girls.
Other risk factors of SCFE include:
The most common complications of slipped capital femoral epiphysis are avascular necrosis and chondrolysis.