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Slipped capital femoral epiphysis

Last reviewed: 10 Sep 2024
Last updated: 23 Nov 2022

Summary

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
  • 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

Randall T. Loder, MD

George J. Garceau Professor of Pediatric Orthopaedic Surgery

Indiana University School of Medicine

Indianapolis

IN

Disclosures

RTL receives book royalties and performs legal consultancy. RTL is an author of a number of references cited in this topic.

Acknowledgements

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

Disclosures

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

Disclosures

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

Disclosures

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.

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