When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Slipped capital femoral epiphysis

最后审阅: 17 Aug 2025
最后更新: 13 May 2025

小结

Definition

History and exam

Key diagnostic factors

  • weight (>90th percentile)
  • gait with affected leg externally rotated
Full details

Other diagnostic factors

  • 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
Full details

Risk factors

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

Diagnostic tests

1st tests to order

  • bilateral anteroposterior radiographs
  • frog-leg lateral radiographs
Full details

Tests to consider

  • metabolic panel
  • serum thyroid function tests
  • serum growth hormone
Full details

Treatment algorithm

ACUTE

unstable SCFE

stable SCFE

ONGOING

late deformity

Contributors

Authors

Jonathan Wright, MBBS, FRCS (Tr & Orth)

Consultant Orthopaedic Surgeon

Catterall Unit, Department of Paediatric Orthopaedics

Royal National Orthopaedic Hospital

Stanmore

London

UK

Disclosures

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

Disclosures

NS declares that he has no competing interests.

Acknowledgements

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.

Disclosures

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.

Peer reviewers

James McCarthy, MD, FAAOS, FAAP

Associate Professor

Department of Orthopedics and Rehabilitation

University of Wisconsin School of Medicine and Public Health

Madison

WI

Disclosures

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

利益声明

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

利益声明

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.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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.全文  摘要

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

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

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

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

内容使用需遵循免责声明