Slipped Capital Femoral Epiphysis
Slipped Capital Femoral Epiphysis is a condition that affects the hip and is characterized by slipping or sliding of the epiphysis from its position within the femur. Although this condition may be treated conservatively, there is the possibility that it may eventually lead to surgery. The article below provides information on the diagnosis, treatment, and conservative options.
Early radiographic signs
Slipped capital femoral epiphysis (SCFE) is a condition where the femoral head slips off the neck of the femur. It can occur suddenly or over time, and it can affect both hips. It is caused by a trauma or weakness of the physis, which weakens the growth plate. It is the most common hip disorder in adolescents. There are two types of SCFE, and both can cause serious complications. It is important to get a diagnosis for your child quickly to prevent worsening conditions.
A diagnosis of slipped capital femoral epiphysis can be made by physical examination, x-rays, or an MRI. The symptoms of a slipped capital femoral epiphysis include pain in the hip, knee, groin, or thigh. This is because the epiphysis is often inflamed. The first symptom is likely to be a limp or hip pain. The pain may be localized or referred to. The type of SCFE will determine the type of treatment and the long-term prognosis. The most severe complication, avascular necrosis, can happen in the later stages of the condition.
Typically, children with slipped capital femoral epiphysis have intermittent pain in the hip. This condition can be very painful and causes a limp that is not relieved by passive motion. The condition can also lead to instability and pain in the knee and groin. The severity of the slippage will also determine the treatment. Usually, a single screw is placed to hold the ball section of the femur in place. In some cases, surgery is required to treat the condition. The goal of this treatment is to prevent further slippage of the femoral head.
Anteroposterior radiographs are often used in the early stages of slipped capital femoral epiphysis. During this stage, the physis is normally weak and can be easily displaced. However, if the blood supply to the epiphysis is compromised, it can collapse. In the event of a slip, the child will need crutches to avoid falling. In addition, the child’s gait will be abnormal.
A child with unstable slipped capital femoral epiphysis will have extreme pain and may be unable to ambulate. This type of slipped capital femoral epiphysis causes an abrupt displacement of the physeal plate. This type of slipped capital femoral encapsulation has a much higher risk of avascular necrosis.
In most cases, a diagnosis of the slipped capital femoral epiphysis is made through physical examination and x-rays. It is possible to diagnose the condition through an MRI, but it is not advisable for children younger than age eighteen. The MRI is useful in determining whether there is chondrolysis, avascular necrosis, or a fracture. It can also be helpful in evaluating the effect of surgery. Using an MRI, a physician can examine the epiphysis, the femoral head, and the acetabulum.
Slipped capital femoral epiphysis (SCFE) is a hip disorder that involves the upper part of the femur (hip bone) slipping out of its socket in the hip joint. It is one of the most common hip disorders seen in pre-teens and is less common in older adolescents. This condition causes pain, stiffness and a limp. When untreated, it can develop into painful arthritis.
The main goal of treatment is to prevent a further slip. This can be done with either conservative or surgical intervention. In general, conservative treatment includes rest, over-the-counter painkillers and physical therapy. In addition, it may involve Spica Casting, hydrotherapeutic exercises and partial weight bearing with crutches. In more severe cases, surgery may be necessary.
In some cases, a CT scan or MRI may be required to make a definitive diagnosis. In other cases, a physician may perform a thorough examination of the affected hip. X-rays of the pelvis and hip can be used to detect whether the slipped portion of the femur has displaced from its normal position. A doctor can also determine the amount of slippage by observing the patient’s gait. A positive diagnosis is very important for the proper management of this condition.
A femoral head that slips out of its socket can cause a lot of problems. It can lead to chronic arthritis and avascular necrosis. Chondrolysis, which is the sudden destruction of the cartilage in the hip joint, is another complication that can arise. In this case, a doctor may recommend arthroscopic treatment to avoid the need for open surgery.
Depending on the severity of the condition, a child may need crutches for six to eight weeks. This can be followed by physical therapy to increase the range of motion and improve muscle strength. In other cases, the doctor may prescribe medication for pain. Then, the child can gradually begin to return to normal activities.
The most commonly used type of surgery is screw fixation. This procedure involves the insertion of a metal screw through the growth plate in the femur. The metal screws then hold the bone in place until the growth plate closes. This treatment is effective in keeping the ball section of the femur from slipping out of place. It is usually used in mild cases. It is also recommended to use three or four small pins.
Other treatments include in situ fixation and open reduction. In an in situ fixation, a small incision is made near the hip. A metal screw is inserted through the growth plate and the femur is then held in place. This procedure can be used for both stable and unstable SCFE. However, the recovery time for an open procedure can be significantly longer.
Other factors that can affect a child’s chances of successful treatment are the severity of the condition, whether the femur has slackened, and the level of activity of the patient. A femoral head that has severely slipped out of its socket can cause avascular necrosis, a serious complication that can cut off blood supply to the femur head. The best way to treat a slipped capital femoral epiphysis is to diagnose the condition early. If the slip is detected before the onset of arthritis, the situation can be treated conservatively.
Reconstructive hip surgery
Slipped capital femoral epiphysis (SCFE) is a common hip disorder affecting children. It usually affects preteens and teens and can cause pain and stiffness in the hip. Symptoms often appear during the growth spurt of early adolescence. If left untreated, the condition can worsen and result in osteoarthritis of the hip joint.
The slipped capital femoral epiphysis is diagnosed using radiographs of the hip. The growth plate, which lies below the femoral head, is weaker than the rest of the bone during adolescence. When this occurs, the femoral head slips backwards and impairs the integrity of the hip joint. In severe cases, the head of the femur collapses, leading to painful arthritis. Several studies have shown that early diagnosis and treatment of slipped capital femoral epiphysis can prevent or delay the development of degenerative hip arthritis.
If the SCFE is stable, the goal of surgery is to stop further slippage. To do this, surgeons may use a metal screw to hold the ball section of the femur in place. This prevents the femoral head from further slipping through the growth plate. After the screw is placed, the patient is placed on a non-weight-bearing schedule for several weeks. A physical therapist will then work on strengthening the leg muscles. After this, the child can resume normal activities.
For milder cases of the slipped capital femoral epiphysis, in situ fixation is used. During this procedure, a small incision is made near the hip and a metal screw is inserted across the growth plate. The screw is held in place until the growth plate closes. If a femoral head continues to slip, the doctor may need to perform open reduction, which involves reducing the femoral head. This procedure is much more invasive and requires a longer recovery period.
An unstable slipped capital femoral epiphysis, on the other hand, is characterized by severe, abrupt displacement of the physeal plate. These patients are generally diagnosed with a limp and a history of episodes of prolonged physical exertion. They also have a history of pain. The pain may be referred to the knee or groin. If the child is unable to walk, they will have to use a wheelchair.
The average age of a child diagnosed with slipped capital femoral epiphysis varies between 12 and 16 years of age. For boys, this age is slightly younger than for girls. Symptoms usually start in less than three weeks. The symptoms of slipped capital femoral epiphysis are often inconsistent, and the time of symptom onset can be difficult to estimate. This makes it hard to accurately predict the prognosis. The long-term outcome of slipped capital femoral epiphysis depends on the type of surgery performed, the severity of the injury, and the patient’s age.
Slipped Capital Femoral Epiphysis | Johns Hopkins Medicine
Slipped Capital Femoral Epiphysis (SCFE): Symptoms, Causes & Treatment (clevelandclinic.org)