Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE) is a condition of the hip joint that affects children. In SCFE, the ball of the thighbone (femoral head) slips off the neck of the thighbone. SCFE is often described as being like a scoop of ice cream slipping off the top of a cone. It can affect one or both hips.

Causes of SCFE

The cause of SCFE is not known. It can occur suddenly after an injury, such as a fall. But it most often happens over a long period of time. SCFE tends to develop during short periods of rapid growth after the start of puberty.

Children Who Are at Risk for SCFE

SCFE is an unusual condition that is more likely to happen in children who are about 10 to 16 years old. Other risk factors that increase the chance of SCFE are:

• Obesity
• Medicines, such as human growth hormone
• Problems with the endocrine system, such as thyroid or growth hormone disorders
• Radiation treatment
• Bone problems linked to kidney disease
• Genetic disorders, such as Down syndrome

Symptoms of SCFE

Children with SCFE may have:

• Pain in the hip that gets worse with activity
• A limp
• Pain in the groin, thigh, or knee
• An outward-turned leg when they walk

These symptoms may start suddenly or develop over time. They may seem like other health problems of the hip. Make sure your child sees a doctor for a diagnosis.

Diagnosing SCFE

Your child's doctor will be able to diagnose SCFE after reviewing your child's health history and doing a physical exam. Your child may also need X-rays or an MRI.

An early diagnosis of SCFE is important to help prevent a hip deformity. Once diagnosed with SCFE, your child may be told not to bear weight on the hip. They may need crutches or a wheelchair.

Treating SCFE

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

The goals of treatment is to prevent the femoral head from slipping further off the thighbone and to help avoid complications. Treatment may include:

• Surgery. This treatment may involve the use of a steel pin or screw to hold the femoral head onto the thighbone to stop it from slipping further.
• Physical therapy. After surgery, physical therapy can help build up the hip and leg muscles.

Children with severe cases of SCFE are more likely to have limited hip motion, differences in leg lengths, and other hip problems in adulthood. But with early detection and correct treatment, a good outcome with few problems is possible.