Health A-Z

Slipped Capital Femoral Epiphysis (SCFE) is a condition that occurs in adolescents when the ball at the head of the thigh bone (femur) slips off the neck of the bone at the growth plate. It typically occurs during periods of rapid growth, often around puberty. Here's an overview of its symptoms, diagnosis, and treatment.

1. Hip or Knee Pain: Pain in the hip, groin, thigh, or knee, which may be mild at first and worsen with activity.
2. Limping: Difficulty walking or a noticeable limp, especially if the pain is severe.
3. Limited Range of Motion: Decreased ability to move the hip joint, particularly with internal rotation and abduction.
4. Leg Length Discrepancy: One leg may appear shorter than the other due to the slip of the femoral head.

1. Surgical Intervention: The primary treatment for SCFE is surgery to stabilize the femoral head and prevent further slippage. The two main surgical procedures are:
   • In Situ Fixation: This involves placing screws or pins across the growth plate to hold the femoral head in its current position.
   • Open Reduction and Internal Fixation (ORIF): In more severe cases, the surgeon may need to reposition the femoral head and stabilize it with screws or pins.
2. Non-Surgical Management: In some cases, especially for mild slips or when surgery is not immediately feasible, non-weight-bearing or partial weight-bearing may be recommended to prevent further displacement of the femoral head.
3. Physical Therapy: Physical therapy exercises may be prescribed to improve hip strength, range of motion, and overall function following surgery or during non-surgical management.
4. Monitoring: Regular follow-up appointments with a healthcare provider are essential to monitor the healing process, assess for complications, and ensure optimal outcomes.

1. Clinical Evaluation: A healthcare provider will perform a physical examination, assessing for hip range of motion, leg length, and any signs of pain or discomfort.
2. Imaging Studies:
   • X-rays: X-rays of the hip will show the characteristic findings of SCFE, including a widening of the growth plate and displacement of the femoral head from the neck of the bone.
   • MRI or CT Scan: In some cases, additional imaging studies may be ordered to evaluate the extent of the slip and assess soft tissue structures around the hip joint.
3. Classification: SCFE is classified based on the severity of the slip:
   • Mild: The femoral head remains partially in place.
   • Moderate: The femoral head is partially displaced.
   • Severe: The femoral head is completely displaced from the neck of the femur.