Slip

Alternative names
Femoral epiphysis - slipped; Slipped capital femoral epiphysis; SCFE

Definition
A slipped capitol femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone.

Causes, incidence, and risk factors

A slipped capitol femoral epiphysis is a condition that is most common in growing children, especially between ages 11 and 15.

An epiphysis is a site located at the end of a long bone. It is separated from the main part of the bone by the physeal plate (growth plate). In this condition, a displacement occurs in the upper epiphysis while the bone is still growing.

It is more common in boys, in children who are obese, and in children who grow rapidly. Children with hormone imbalances caused by other conditions are at particular risk for this disorder.

Symptoms

     
  • knee pain  
  • hip pain  
  • leg turns outward  
  • hip movements are restricted  
  • hip stiffness  
  • difficulty walking, walking with a limp

Signs and tests
During a physical examination, the doctor will look for restricted hip motion and pain with attempted hip movement. A hip X-ray or pelvis X-ray shows displacement.

Treatment
Surgery to stabilize the bone with pins or screws will prevent further displacement of the ball of the hip joint (i.e., prevents further “slippage”).

Expectations (prognosis)
The outcome is usually good with treatment. However, in rare cases, the hip joint may degenerate. Most experts agree that this is due primarily to the displacement of the growth plate in which the blood supply to the ball of the hip is disrupted. Because this is related to the severity of the condition itself, the joint may degenerate despite prompt recognition and treatment.

Complications
This disorder is associated with a greater risk of osteoarthritis later in life. Other potential but rare complications include diminished blood flow to the hip joint and thinning of the cartilage in the hip joint.

Calling your health care provider
If your child experiences persistent pain or other symptoms suggestive of this disorder, have the child lie down immediately and do not let him or her walk until medical attention has been obtained.

Prevention
Weight control for obese children may be helpful. Many cases are not preventable.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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