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Slipped capital femoral epiphysis in Adult
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Slipped capital femoral epiphysis in Adult

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Contributors: Eric Ingerowski MD, FAAP, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Slipped capital femoral epiphysis (SCFE) is an important condition of the hip that can occur in preteens and adolescents who still have open growth plates. SCFE involves a fracture (Salter-Harris type 1) through the physis with slippage of the capital (head of the femur) in relation to the femoral neck (epiphysis). While there is no definitive cause, several factors may contribute, including obesity (present in a majority of cases), endocrine disorders (hypothyroidism, osteodystrophy, hypopituitarism), and orthopedic conditions (coxa profunda, acetabular retroversion), and possibly family history. Additional risk factors include genetic disorders (trisomy 21, Rubenstein-Taybi syndrome), renal disease, and some cancer treatments.

Symptoms can be variable, but most patients typically present with gait disturbances and pain in the groin, hip, medial thigh, or knee area with activity. While SCFE can present after trauma, a vast majority of cases involve no history of trauma and present with intermittent pain (usually with activity) for weeks to months. The pain can be bilateral since SCFE occurs bilaterally in about 40% of cases. The left hip is more often affected than the right.

SCFE is twice as common in boys (aged 12-16) than girls (aged 10-14), with the age ranges correlating with rapid bone growth. Children younger than 10 who have metabolic disorders may also develop SCFE that is often bilateral.

Codes

ICD10CM:
M93.003 – Unspecified slipped upper femoral epiphysis (nontraumatic), unspecified hip

SNOMEDCT:
26460006 – Slipped upper femoral epiphysis

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Last Updated: 05/30/2017
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Slipped capital femoral epiphysis in Adult
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Slipped capital femoral epiphysis (Slipped Capital Femoral Epiphysis) : Gait disturbance, Hip pain
Imaging Studies image of Slipped capital femoral epiphysis
Widening and irregularity of the right hip physis, with mild posteromedial slip of the epiphysis relative to the metaphysis. Findings are compatible with SCFE. Note the normal appearance of the left hip physis.
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