Which clinical history findings are characteristic of slipped capital femoral epiphysis (SCFE)?

Updated: Dec 03, 2018
  • Author: Kevin D Walter, MD, FAAP; Chief Editor: Craig C Young, MD  more...
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Answer

See the list below:

  • Slipped capital femoral epiphysis (SCFE) is most common in the adolescent period (ie, boys aged 10-16 y, girls aged 12-14 y). Males have 2.4 times the risk compared with females.

  • The left hip is affected more commonly than the right.

  • Obesity is a risk factor because it places more shear forces around the proximal growth plate in the hip at risk. [22, 23]

  • The duration, location, and radiation of pain are important, as is the ability to bear weight.

  • Genetics may play a role in SCFE because the rate of familial involvement is 5-7%, with a large variability in penetrance.

  • In patients younger than 10 years, SCFE is associated with metabolic endocrine disorders (eg, hypothyroidism, panhypopituitarism, hypogonadism, renal osteodystrophy, growth hormone abnormalities). [1, 27, 28] Bilaterality is more common in these younger patients.

  • The chronicity of the condition should be determined.

    • Prodromal symptoms (eg, hip or knee pain, limp, decreased range of motion) for less than 3 weeks are deemed acute.

    • Prodromal symptoms for longer than 3 weeks are deemed chronic.

    • If a patient reports symptoms of greater than 3 weeks' duration but presents with an acute exacerbation of pain, limp, inability to bear weight, or decreased range of motion with or without an associated traumatic episode, the SCFE is categorized as acute on chronic.

    • Determine if a traumatic episode occurred.

  • It is important to determine if the lesion is stable or unstable.

    • "Stable" SCFEs allow the patient to ambulate with or without crutches. [8]

    • "Unstable" SCFEs do not allow the patient to ambulate at all; these cases carry a higher rate of complication, particularly of AVN. [8]


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