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