Slipped capital femoral epiphysis

From greek.doctor
  • Slipped capital femoral epiphysis = Juvenile slipped upper femoral epiphysis
  • Epidemiology
    • Most common hip disorder in adolescents
    • Males > females
    • 6 – 16 years
  • Etiology
    • Unknown cause
    • GH and sex hormone imbalance may be involved
    • Obesity and family history are risk factors
  • Pathology
    • The femoral head (epiphysis) slips off the neck (metaphysis) in the line of the growth plate
    • Can be acute or chronic
  • Clinical features
    • Often bilateral
    • Acute type
      • Sudden onset pain
    • Chronic type
      • Nagging groin/thigh/knee pain
      • Antalgic gait
    • Flexion, abduction, and internal rotation contracture
    • Features of sex hormone imbalance
      • Fat
      • No pubic hair
      • Delayed sexual development
  • Diagnosis
    • X-ray
    • MRI
  • Treatment
    • Always surgical – there is no conservative treatment
    • Urgent surgical internal fixation with screwing of the femoral head
      • Percutaneous procedure
      • Screw can be removed when child is done growing