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Slipped capital femoral epiphysis

Última revisão: 12 Aug 2025
Última atualização: 13 May 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • weight (>90th percentile)
  • gait with affected leg externally rotated
Detalhes completos

Outros fatores diagnósticos

  • groin or knee pain
  • bilateral hip pain
  • Trendelenburg gait
  • restricted range of motion
  • weight (<50th percentile)
  • symptoms of hypothyroidism or panhypopituitarism
  • renal failure
  • recent trauma
Detalhes completos

Fatores de risco

  • puberty
  • African-American ancestry
  • Hispanic ancestry
  • northeastern or western US
  • obesity
  • male sex
  • endocrine disorders
  • vitamin D deficiency
  • prior radiation therapy
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • bilateral anteroposterior radiographs
  • frog-leg lateral radiographs
Detalhes completos

Investigações a serem consideradas

  • metabolic panel
  • serum thyroid function tests
  • serum growth hormone
Detalhes completos

Algoritmo de tratamento

AGUDA

unstable SCFE

stable SCFE

CONTÍNUA

late deformity

Colaboradores

Autores

Jonathan Wright, MBBS, FRCS (Tr & Orth)

Consultant Orthopaedic Surgeon

Catterall Unit, Department of Paediatric Orthopaedics

Royal National Orthopaedic Hospital

Stanmore

London

UK

Declarações

JW is an author of a reference cited in this topic.

Neil Segaren, MBBS, FRCS

Consultant Orthopaedic Surgeon

Catterall Unit, Department of Paediatric Orthopaedics

Royal National Orthopaedic Hospital

Stanmore

London

UK

Declarações

NS declares that he has no competing interests.

Agradecimentos

Mr Jonathan Wright and Mr Neil Segaren would like to gratefully acknowledge Dr Randall T. Loder, Dr John M. Flynn, Dr Purushottam A. Gholve, Dr Danielle B. Cameron, and Dr Patrick O'Toole, previous contributors to this topic.

Declarações

RTL receives book royalties and performs legal consultancy. RTL is an author of a number of references cited in this topic. JMF, PAG, DBC, and PO declare that they have no competing interests.

Revisores

James McCarthy, MD, FAAOS, FAAP

Associate Professor

Department of Orthopedics and Rehabilitation

University of Wisconsin School of Medicine and Public Health

Madison

WI

Declarações

JM declares that he has no competing interests.

D. Philip Thomas, MB, BS, FRCS

Consultant Orthopaedic Surgeon and Honorary Lecturer

University Hospital of Wales

Cardiff

UK

Declarações

DPT declares that he has no competing interests.

Nicholas M. Clarke, ChM, FRCS

Professor

Consultant Orthopaedic Surgeon

Developmental Origins of Health and Disease (DOHaD)

School of Medicine

University of Southampton

Southampton

UK

Declarações

NMC has received honoraria for visiting professorships in North America and also for lectures in respect of congenital hip dysplasia. He is also a founding member of the International Hip Dysplasia Institute, which has received charitable funding.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Perry DC, Arch B, Appelbe D, et al. The British Orthopaedic Surgery Surveillance study: slipped capital femoral epiphysis: the epidemiology and two-year outcomes from a prospective cohort in Great Britain. Bone Joint J. 2022 Apr;104-B(4):519-28.Texto completo  Resumo

Aprato A, Conti A, Bertolo F, et al. Slipped capital femoral epiphysis: current management strategies. Orthop Res Rev. 2019;11:47-54.Texto completo  Resumo

Sucato DJ. Approach to the hip for SCFE: the North American perspective. J Pediatr Orthop. 2018 Jul;38 Suppl 1:S5-12.Texto completo  Resumo

Wright J, Ramachandran M. Slipped capital femoral epiphysis: the European perspective. J Pediatr Orthop. 2018 Jul;38 Suppl 1:S1-4.Texto completo  Resumo

Artigos de referência

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