In addition to a complete medical history and physical examination, diagnostic procedures for SCFE may include:
- X-ray: a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film. To diagnose SCFE, front and side views are usually needed, as well as views of the opposite knee.
- MRI (magnetic resonance imaging)
- bone scan, blood tests (rarely needed)
How is SCFE diagnosed in children?
SCFE is diagnosed through physical exam including rotation of the affected leg, observation while walking and X-rays. A MRI may be ordered if the diagnosis is not able to be made with X-rays and your healthcare provider still suspects your child has SCFE. Your provider may also order blood work to check for other medical conditions.
What does SCFE stand for?
Slipped capital femoral epiphysis (SCFE) Epiphyseolysis of femoral head URL of Article Slipped upper femoral epiphysis (SUFE), also known as a slipped capital femoral epiphysis (SCFE), (plural: epiphyses) is a relatively common condition affecting the physis of the proximal femurin adolescents.
How do you diagnose slipped capital femoral epiphysis?
Slipped capital femoral epiphysis Diagnosis The pediatric orthopaedic specialist will obtain a complete medical history and do a thorough physical exam. He/she will also order x-rays which will make the final diagnosis. In rare instances, an MRI may be needed if the x-rays are inconclusive.
How are X-rays used to diagnose SCF?
X-rays provide images of dense structures, such as bone. Your child's doctor will order X-rays of the pelvis, hip, and thigh from two different angles to help confirm the diagnosis. In a patient with SCFE, an X-ray will show that the head of the femur appears to be slipping off the neck of the bone.
What does SCFE feel like?
Usually, SCFE is classified as: Stable. A stable SCFE causes some stiffness or pain in the knee or groin area, and possibly a limp that causes a child to walk with a foot outward. The pain and the limp may come and go, and may get worse with activity and better with rest.
Can SCFE be missed?
Slipped capital femoral epiphysis (SCFE) is a fairly common condition affecting older children and adolescents, and has the potential for long-term, crippling sequelae. Early recognition is the single most important controllable factor, but the diagnosis is often missed or delayed, resulting in progression of the slip.
What happens if SCFE is not treated?
Untreated SCFE may result in progressive deformity and pain, destabilization of the femoral epiphysis, and decreased range of motion of the hip joint.
How is SCFE treated?
This causes pain, stiffness, and instability in the affected hip. The condition usually develops gradually over time. Treatment for SCFE involves surgery to stop the head of the femur from slipping any further. To achieve the best outcome, it is important to be diagnosed as quickly as possible.
Can SCFE be missed on xray?
While the SCFE can be missed on AP films (a), the slip is obvious on frog-lateral view (b; arrow). A cross-table view with the patient in a lateral position may decrease the patient's discomfort for obtaining a lateral view.
Is SCFE an emergency?
SCFE is usually an emergency and must be diagnosed and treated early. In 20 to 40 percent of affected children, SCFE will be present in both hips at the time the child is diagnosed. If only one hip is affected, the other hip will eventually slip 30 to 60 percent of the time. Treatment is surgical.
Can you play sports with SCFE?
Depending on the severity of the slippage, most children may return to sports about 6 months after an operation to treat a slipped capital femoral epiphysis. Some contact and collision sports may be restricted, especially in children with more severe cases.
Can SCFE heal on its own?
Early in the disease process, the body is sometimes able to heal itself by making new bone and strengthening the connection. Your child may then go weeks, months, or even years before the next episode of pain. Even more interesting is that some children grow into adulthood before they develop any hip pain.
Does SCFE lead to hip replacement?
In some patients residual SCFE deformity is associated with advanced osteoarthritis and the only effective treatment may be a total hip replacement.
What is the recovery time for SCFE surgery?
The majority of patients with a slipped capital femoral epiphysis will be able to return to most sports and activities at approximately 3-6 months post-operatively. Removing the hardware is not necessary unless the patient develops pain or there is a problem with the screw itself.
What is SCFE caused by?
The exact cause of SCFE is not known. There are, however, many factors that are associated with this condition. These factors lead to weakening of the growth plate (also called the “physis”) which then causes the femoral head (ball of the femur) to slip off the neck of the femur. Obesity is a major risk factor.
What is the most common age range for slipped capital femoral epiphysis?
Slipped capital femoral epiphysis (SCFE) is a condition typically affecting adolescents, during the period of rapid growth, from 10-15 years of age.
Is SCFE surgery outpatient?
Once the diagnosis of SCFE is made, surgery is usually suggested immediately. The surgery is scheduled within a few days following the diagnosis. Until the surgery can be performed, it is highly advisable to use crutches and restrict activities to a minimum. The surgery can usually be done as an outpatient.
Can you walk after SCFE surgery?
What happens after surgery? After surgery to fix a SCFE, the child will need to walk with crutches for 6 to 8 weeks. The child may be referred to a physical therapist for treatment during recovery. Follow-up is vital every 3 to 4 months for the next several years to recheck the treated hip.
Is SCFE a disability?
SCFE occurs through the unfused growth plate of the proximal femur where the femoral head slips posteriorly on the femoral neck. Serious consequences of the problem, such as gait disturbance, post-traumatic arthritis, chondrolysis and osteonecrosis of the femoral head can occur, leading to lifelong disability.
Can SCFE happen in adults?
Slipped capital femoral epiphysis (SCFE) is a hip condition which predominantly occurs in adolescents. SCFE is characterized by posteroinferior displacement of the femoral epiphysis on the metaphysis through an open physis. SCFE is extremely rare in adults.
What is the result of SCFE?
The first is “ osteonecrosis .” “Osteo” means bone and “necrosis” means death. In osteonecrosis, the blood supply to the femoral head is damaged and the bone dies.
What are the complications of SCFE?
The first is “ osteonecrosis .” “Osteo” means bone and “necrosis” means death . In osteonecrosis , the blood supply to the femoral head is damaged and the bone dies. This can lead to degenerative joint disease ( osteoarthritis ). The other complication is called “chondrolysis”. “Chondro” means cartilage and “lysis” means cutting apart. In this complication, the joint cartilage is damaged and leads to a painful and stiff joint.
What is the capital femoral epiphysis?
The ball fits inside of a “cup” that is made up of the pelvic bones and is known as the acetabulum. During growth, the end of the head is known as the epiphysis and is connected to the rest of the femur by the growth plate.
What causes slipped capital femoral epiphysis?
The exact cause of SCFE is not known. There are, however, many factors that are associated with this condition. These factors lead to weakening of the growth plate (also called the “physis”) which then causes the femoral head (ball of the femur) to slip off the neck of the femur. Obesity is a major risk factor. Certain endocrine disorders are risk factors for SCFE, such as hypothyroidism and osteodystrophy. There may be a genetic predisposition to this condition (it runs in families). Boys are more often affected than girls.
How to treat SCFE?
Procedures used to treat SCFE include: In situ fixation. This is the procedure used most often for patients with stable or mild SCFE. The doctor makes a small incision near the hip, then inserts a metal screw across the growth plate to maintain the position of the femoral head and prevent any further slippage.
What is the treatment for SCFE?
The condition usually develops gradually over time and is more common in boys than girls. Treatment for SCFE involves surgery to stop the head of the femur from slipping any further.
Why is SCFE more common in boys than girls?
The cause of SCFE is not known. The condition is more likely to occur during a growth spurt and is more common in boys than girls. Risk factors that make someone more likely to develop the condition include: Excessive weight or obesity—most patients are above the 95th percentile for weight. Family history of SCFE.
What are the complications of SCFE?
Complications following SCFE include avascular necrosis (degeneration of the femoral head), chondrolysis (rapid onset of painful arthritis), and impingement.
How long does it take for SCFE to develop?
Sometimes SCFE occurs suddenly after a minor fall or trauma. More often, however, the condition develops gradually over several weeks or months, with no previous injury.
What are the risk factors for SCFE?
Risk factors that make someone more likely to develop the condition include: 1 Excessive weight or obesity—most patients are above the 95th percentile for weight 2 Family history of SCFE 3 An endocrine or metabolic disorder, such as hyperthyroidism—this is more likely to be a factor for patients who are older or younger than the typical age range for SCFE (10 to 16 years of age)
What is stable SCFE?
Stable SCFE. In stable SCFE, the patient is able to walk or bear weight on the affected hip, either with or without crutches. Most cases of SCFE are stable slips. Unstable SCFE. This is a more severe slip. The patient cannot walk or bear weight, even with crutches.
What Causes SCFE?
The cause of SCFE is unknown. It is 2-3 times more common in males, and a large number of patients are overweight.
What is the number to call for a child with a slipped capital femoral epiphysis?
If your child has been diagnosed with Slipped Capital Femoral Epiphysis and you would like to schedule a consultation with one of our orthopaedic surgeons, call Children’s Orthopaedic and Scoliosis Surgery Associates (COSSA), L.L.P., at 727-898-2663. Surgical treatment for sports injuries at Johns Hopkins All Children’s is provided by the surgeons at COSSA.
What is Slipped Capital Femoral Epiphysis?
Slipped Capital Femoral Epiphysis (SCFE) is an unusual disorder of the hip. For reasons that are not well understood, the ball at the upper end of the femur slips off. This is due to weakness of the growth plate and often develops during periods of accelerated growth, shortly after the onset of puberty.
What is the best phone number to call for a hip epphysis?
If your child has hip pain and you’re concerned he or she may have a Slipped Capital Femoral Epiphysis, call 727-76SPORT to schedule an appointment with our Sports Medicine physicians, who will determine a diagnosis and recommend further treatment..
How is slipped capital femoral epiphysis diagnosed?
SCFE is often diagnosed by examining the child and watching him or her walk. An imaging test such as an X-ray is done to confirm the diagnosis. In some cases, additional imaging studies such as an MRI may be needed. Other tests may be done to check for an underlying problem (such as a thyroid problem) that could cause the SCFE.
What are the causes of slipped capital femoral epiphysis?
In some cases, SCFE occurs suddenly due to an injury or trauma. In other cases, it develops slowly over time due to an underlying problem. In many cases, the cause of SCFE is not known. Risk factors include:
Is SCFE a good treatment?
With treatment, SCFE often has a good outcome, especially if treated early. Your child’s doctor can tell you more.
Can a child with SCFE have a slipped hip?
In a child with SCFE in one hip, the other hip may be at increased risk of slipping. This is especially true if an underlying problem led to the SCFE, or if the child is younger than age 10. In these cases , the surge on may recommend pinning the other hip along with the slipped hip. This prevents problems in the future.
When is a slip diagnosis made?
When the slip is evident, and no secondary degenerative changes are present, then the diagnosis is usually readily made. Ideally, however, the diagnosis is made early in which case the differential is that of a painful hip and includes:
Which line fails to intersect the epiphysis during the acute phase?
On the AP, a line drawn up the lateral edge of the femoral neck ( line of Klein) fails to intersect the epiphysis during the acute phase ( Trethowan sign ).
What is alignment of epiphysis with respect to the femoral metaphysis used for?
Alignment of the epiphysis with respect to the femoral metaphysis can be used to grade the degree of slippage: see SUFE grading.
What is a slipped epiphysis?
Slipped upper femoral epiphysis (SUFE) , also known as a slipped capital femoral epiphysis (SCFE), (plural: epiphyses) is a relatively common condition affecting the physis of the proximal femur in adolescents. It is one of the commonest hip abnormalities in adolescence and is bilateral in ~20% of cases.
What conditions can cause SUFE?
Conditions that may predispose to SUFE include: hypothyroidism. hypopituitarism. hyperparathyroidism. obesity 6. renal osteodystrophy 7. radiation/chemotherapy 8.
Which is more easily seen on the frog leg lateral view than the AP hip view?
The slip that occurs is posterior and, to a lesser extent, medial. It is therefore is more easily seen on the frog-leg lateral view rather than the AP hip view. Because the epiphysis moves posteriorly, it appears smaller because of projectional factors.
Can a child be weight bearing with slipped femoral epiphysis?
If slipped upper femoral epiphysis is confirmed on imaging, the child should be rested, admitted, and not allowed to weight-bear.
