Slipped Capital Femoral Epiphysis | Diagnosis & Treatments

How is slipped capital femoral epiphysis diagnosed?

At Boston Children's Hospital, we know that the first step to treating your child’s slipped capital femoral epiphysis (SCFE) is to form a complete and accurate diagnosis.

Our goal is to diagnose SCFE early in order to prevent the head of the thigh bone from slipping further, and thus preventing hip deformity. If your child receives a diagnosis of SCFE, he or she must avoid putting weight on the hip until after treatment and may be instructed to use crutches or a wheelchair until after receiving treatment.

Your child’s doctor will conduct a physical exam, during which he or she can often feel the ball popping in and out of the socket. The doctor will also take a family history (including any hip problems in your family) and may use diagnostic tests to get detailed images of your child’s hip joint.

In addition to a complete medical history and physical examination, diagnostic procedures for SCFE may include:

  • X-ray: a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film. To diagnose SCFE, front and side views are usually needed, as well as views of the opposite knee.
  • MRI (magnetic resonance imaging)  
  • bone scan, blood tests (rarely needed)

How is slipped capital femoral epiphysis treated?

The goal of treatment is to prevent the femoral head from further slippage, to avoid complications and eliminate hip impingement, which can cause arthritis later in life.

The standard of care for SCFE is limited open surgery, which uses steel screws and pins (internal fixation) to hold the femoral head onto the femur to stabilize it and prevent from slipping further. Some children need more complex surgery to realign the femur or reshape the bone.

If a child who has a mild case of SCFE remains relatively pain-free, parents may be tempted to leave their child’s diagnosed condition untreated. However, left untreated, SCFE almost always worsens with time — and the ball may completely slip off. Even if the child grows to adolescence without developing serious pain or a noticeable limp, it’s inevitable that the untreated hip will wear out and become arthritic in adulthood.

Long-term outlook for a child with slipped capital femoral epiphysis

Success rates are high for SCFE treatment at Boston Children’s. Treating your child’s hip as soon as symptoms develop greatly increases the likelihood of a successful outcome. Most children treated for SCFE at Boston Children’s have treatments that enable them walk, play, grow and live active lives.

However, a significant percentage of children with SCFE in one hip will eventually develop the condition in the other hip. Your child should continue to be followed by an orthopedist at least until skeletal growth is complete. Your doctor will also monitor your child’s repaired hip, since it needs to grow normally through the whole growth period in order to be durable for a lifetime.