Detailed and well illustrated information

Report of an article on the subject.

Abstract The etiology of slipped capital femoral epiphysis is still unknown. Traumatic, endocrine, toxic, and mechanical causes have all been hypothesized. It is well documented that the highest incidence occurs during the adolescent growth spurt, suggesting the role of an endocrine abnormality. We report a case that supports this hypothesis Skeletal Radiology Volume 26, Number 3 / March, 1997 Authors A. Feydy, R. Y. Carlier, D. Mompoint, G. Rougereau, A. Patel, C. Vallée

BILATERAL SLIPPED CAPITAL FEMORAL EPIPHYSIS

J R Soc Med. 2002 July; 95(7): 356–358. (full text)
Treatment of slipped upper femoral epiphysis (SUFE) is directed at preventing progressive slippage, minimizing deformity and avoiding avascular necrosis and chondrolysis. Delay in treatment adversely affects long-term outcomes. In a retrospective study we assessed delays between symptom onset and evaluation of the patient in an orthopaedic department. 27 patients aged 10-16 years were grouped by source of referral (general practitioner or accident and emergency department), and hips were classified as stable or unstable according to ability to bear weight. The 27 children had 37 affected hips, 31 stable and 6 unstable. In the 20 patients referred by general practitioners, mean delay from symptom onset to orthopaedic evaluation was 119 days (range 2-504); in the 7 referred from accident and emergency departments it was 95 days (1-482). In the latter group the slips were more likely to be acute and unstable. 9 (45%) of the patients in the general-practitioner group had hip radiography before referral, all correctly diagnosed though not all the examinations included the recommended frog-lateral views. Long delays between onset and diagnosis of SUFE are most likely in patients with mild symptoms, able to bear weight on the hip. Any adolescent with undiagnosed hip or knee pain that has lasted more than a week should undergo radiological investigation of the hip, with frog-lateral as well as anteroposterior views.

J R Soc Med. 1981 August; 74(8): 626–627
P H Gibson Full text

Overview with answers to commonly asked questions about this limping condition

Overview of this limping condition including causes, symptoms, and treatment

AAOS Online Service Fact Sheet Slipped Capital Femoral Epiphysis Highly Reputable

Br Med J (Clin Res Ed). 1986 July 26; 293(6541): 256–257. I J Brenkel, A J Prosser, and M Pearse Full Text

Synonyms and related keywords: SCFE, adolescent coxa vara, slipped upper femoral epiphysis (SUFE), knee pain, hip pain, knee injury, hip injury
Contents - Introduction Indications Relevant Anatomy And Contraindications Workup Treatment Complications Outcome And Prognosis Future And Controversies Pictures Bibliography
The term slipped capital femoral epiphysis is a misnomer because the epiphysis is held in the acetabulum by the ligamentum teres; thus, the metaphysis actually moves proximally and anteriorly while the epiphysis remains in the acetabulum. In most patients, this appears radiographically as a varus relationship between the head and the neck. Occasionally, the slip appears to be in a valgus position, with the epiphysis displaced superiorly in relation to the neck

Contents - Introduction Differentials Radiograph CT Scan MRI Ultrasound Nuclear Medicine Intervention Pictures Bibliography
Slipped capital femoral epiphysis (SCFE) is the most common hip abnormality presenting in adolescence and a primary cause of early osteoarthritis. Unfortunately, SCFE frequently is misdiagnosed, and it has symptoms that can be misleading. Early treatment leads to better outcome but is confounded by frequent delays in diagnosis.

Synonyms and related keywords: SCFE, hip disorder, slipped hip, adolescent hip disorder, femoral head displacement, Salter-Harris physeal fracture, Salter-Harris fracture, hip pain, hip joint pain
Contents - Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Multimedia References
Slipped capital femoral epiphysis (SCFE) persists as one of the most common adolescent hip disorders encountered in orthopedic practice. While the underlying defect may be multifactorial (eg, mechanical and constitutional factors), SCFE represents a unique type of instability of the proximal femoral growth plate. Clinically, the patient may report hip, medial thigh, and/or knee pain; an acute or insidious onset of a limp; and possible decreased range of motion. On x-ray films, the femoral head is seen displaced in varying degrees, posteriorly and inferiorly in relation to the femoral neck and within the confines of the acetabulum. Treatment is primarily operative internal fixation

Search string allintitle: slipped epiphysis yielded 11,300 sites in July 2007. The majority of these sites are patient information.

Wheeless' Textbook of Orthopaedics
- slip of the captial femoral epiphysis occurs with in a narrow window of physiologic maturity of the growing child; - arises from mechanical and constitutional factors; - pts may have underlying endocrine dz (such as hypothyroidism) delayed puberty & bone age; - position of growth plate of proximal femur normally changes from horizontal to to obliqueduring preadolescence and adolescence; - wt increase that occurs during adolescent growth spurt puts extra strain on the growth plate; - remember that bilateral involvement is occurs in over 25% of patients - often within 6 months of the other side;