What are the other Names for this Condition? (Also known as/Synonyms)

• SCFE (Slipped Capital Femoral Epiphysis) 

What is Slipped Capital Femoral Epiphysis? (Definition/Background Information)

• Slipped Capital Femoral Epiphysis (SCFE) is rare and abnormal disorder of the hip joint that usually affects children and adolescents, during their growth and development phase
• As children grow and become stronger, added weight and pressure on the hip joint may cause the thighbone (femur) to slip-off the growth plate. This causes hip pain, difficulty in walking, and hip stiffness
• SCFE is caused by a weakness of the growth plate, which results when the ball of the hip joint separates from the upper end of the thigh bone
• Slipped Capital Femoral Epiphysis usually affects one joint. In rare cases, both hip joints may be affected 

Slipped Capital Femoral Epiphysis is associated with 3 levels of severity, which include:

• Mild: Mild severity is identified, when approximately one-third of the upper end of the femur slips-off the thigh bone
• Moderate: Moderate severity is identified, when approximately between one-third and one-half of the upper ends of the femur slips-off the thigh bone
• Severe: Severe Slipped Capital Femoral Epiphysis is identified, when over one-half of the femoral head slips-off the thigh bone 

Who gets Slipped Capital Femoral Epiphysis? (Age and Sex Distribution)

• Children of all ages, race, ethnic groups, and sexual orientation may develop Slipped Capital Femoral Epiphysis
• However, male children between the ages of 11-16 years have a 2-3 times higher chance of SCFE, than female children
• Ethnic Pacific Islanders have the highest prevalence of SCFE, than any other geographical or regional group. This hip disorder is also 2-times more common in African American children than Caucasian children 

What are the Risk Factors for Slipped Capital Femoral Epiphysis? (Predisposing Factors)

The underlying cause for Slipped Capital Femoral Epiphysis is unknown. However, certain risk factors that may contribute to the development of this condition include:

• Age: SCFE generally occurs in children, who are 11-16 years old
• Gender: It is 2-3 times more likely to develop in male children
• Childhood obesity: Excess body weight associated with obesity may cause an increased pressure on the joints, which may increase the child’s risk
• Family history: Children, who have a family history of Slipped Capital Femoral Epiphysis, have an increased risk of developing the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Slipped Capital Femoral Epiphysis? (Etiology)

The underlying cause of Slipped Capital Femoral Epiphysis is unknown. However, some contributing factors that may cause this condition include:

• Childhood obesity: Excess body weight associated with obesity in children may cause the development of SCFE. A high percentage of children who develop this condition are overweight
• Trauma or falls can contribute to make SCFE worse: Generally, this condition progresses slowly; however, accidents, direct trauma, or falls, may cause an aggravation of the condition with rapid development 

What are the Signs and Symptoms of Slipped Capital Femoral Epiphysis?

The signs and symptoms of Slipped Capital Femoral Epiphysis include:

• Difficultly walking, pain within the hip joint
• Stiffness observed within the hip
• Limited hip movability 

How is Slipped Capital Femoral Epiphysis Diagnosed?

Common tests a physician might use to diagnose Slipped Capital Femoral Epiphysis include:

• Physical examination: A thorough physical examination can help identify, if the hip has (or does not have) a normal range of motion
• Pelvic x-ray: Pelvic x-rays are used to identify if SCFE exists. It can also help rule-out other factors that may cause a hip pain
• Magnetic resonance imaging (MRI) of the hip joint: An MRI is a more detailed scan that uses radio waves and a magnetic field to produce images that allow a physician to view, if there is any visual damage to the hip
• Bone scan: A bone scan is an image test used to locate any abnormalities within the hip, by injecting tiny amounts of radioactive material into the bloodstream
• Blood test: A blood test is a routine test used to diagnose various disease and conditions. During this test, a needle is used to take a blood sample that is withdrawn from an artery or vein. The blood sample is then sent to a laboratory for analysis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Slipped Capital Femoral Epiphysis?

• Children who develop Slipped Capital Femoral Epiphysis have a higher risk of osteoarthritis, at some point in their life
• Another possible, but rare complication is the decreased flow of blood to the hip joint (termed avascular necrosis) 

How is Slipped Capital Femoral Epiphysis Treated?

If a child is diagnosed with Slipped Capital Femoral Epiphysis, surgical treatment is required. This may involve:

• In-situ fixation: In-situ fixation is a surgical intervention procedure that is usually used to treat SCFE. During this procedure, plates or rods are inserted into the thighbone and femoral epiphysis, which prevent further progression of this deformity
• Open reduction of Slipped Capital Femoral Epiphysis: Open reduction is a surgical procedure that involves surgically exposing the area and directly manipulating the hip joint back into its correct anatomic position. This procedure is performed to prevent the loss of blood flow to the femoral head and is performed under general anesthesia 

How can Slipped Capital Femoral Epiphysis be Prevented?

Currently there are no definitive methods available to prevent Slipped Capital Femoral Epiphysis. However, the following measure may be helpful:

• Healthy body weight: Children, who maintain a healthy body weight can severely reduce the risk of developing this condition 

What is the Prognosis of Slipped Capital Femoral Epiphysis? (Outcomes/Resolutions)

• The prognosis of Slipped Capital Femoral Epiphysis is usually favorable, if diagnosed and treated early
• However, severe damage of the hip may occur in some rare cases, even with immediate medical treatment 

Additional and Relevant Useful Information for Slipped Capital Femoral Epiphysis:

• Slipped Capital Femoral Epiphysis is an infrequent childhood condition that occurs in approximately 2 out of 100,000 children
• The condition may be bilateral, meaning that it may involve both the hips; this occurs in approximately 25-40% of the children affected with SCFE