Last reviewed: 25 Aug 2021
Last updated: 30 Mar 2021

Summary

Definition

History and exam

Key diagnostic factors

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

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

Risk factors

  • puberty
  • African-American ancestry
  • Hispanic ancestry
  • northeastern or western US
  • obesity
  • male┬ásex
  • endocrine disorders
  • prior radiation therapy

Diagnostic investigations

1st investigations to order

  • bilateral anteroposterior radiographs
  • frog-leg lateral radiographs

Investigations to consider

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

Treatment algorithm

Contributors

Authors

Randall T. Loder, MD

George J. Garceau Professor of Pediatric Orthopaedic Surgery

Indiana University School of Medicine

Indianapolis

IN

Disclosures

RTL is on the editorial board of JPO and JCO. He has provided expert testimony regarding slipped capital femoral epiphysis and received book royalties. 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. 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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