Slipped Capital Femoral Epiphysis | Symptoms and Causes

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What are the symptoms of slipped capital femoral epiphysis?

Some signs and symptoms can include:

  • pain in the hip that’s aggravated by activity and that may subside with rest
  • pain in the groin, thigh or knee in addition to—or instead of—hip pain
  • walking with a limp, trouble walking, or feeling like the leg is "giving way"
  • walking with a leg turned outward (unilateral slip)
  • walking with a waddle (bilateral slip)
  • inability to sit with knees straight ahead (knees tend to turn outward)

What causes slipped capital femoral epiphysis?

In pre-adolescent and adolescent growth and development, a child is growing quickly as adult hormones begin to circulate in his or her system. The growth plate (the area at the end of bone responsible for growth, which is not as strong as bone) gets weaker because it’s broadening. These phenomena, combined with certain anatomical factors, such as the shapes of the femur and the socket, can lead to slippage.

Slipped capital femoral epiphysis (SCFE) is rare condition that is slightly more likely to occur in boys than girls. SCFE occurs in about one per 1,000 to one per 10,000 children and teens; children ages 12 to 14 years are most at risk. SCFE is more prevalent in the northeast region of the U.S. than in the southwest and is more prevalent among African-Americans.

Risk factors that increase the likelihood of SCFE include:

  • obesity
  • hormonal abnormalities (thyroid, etc.)
  • genetic predisposition (runs in families)
  • medications, such as steroids
  • radiation treatment
  • chemotherapy
  • bone problems related to kidney disease

SCFE is usually an emergency and must be diagnosed and treated early. In 20 to 40 percent of affected children, SCFE will be present in both hips at the time the child is diagnosed. If only one hip is affected, the other hip will eventually slip 30 to 60 percent of the time. Treatment is surgical.

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