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Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis is a topic covered in the 5-Minute Pediatric Consult.

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Basics

Description

Slipped capital femoral epiphysis (SCFE) is displacement of the femoral head (epiphysis) relative to the femoral neck (metaphysis).

Epidemiology

  • Most common adolescent hip disorder
  • Male > female (3:2)
  • Up to 25% bilateral at presentation
  • 20–40% have contralateral involvement at some point.

Incidence

  • 2 to 7 per 100,000
  • Age of onset: males 13 to 15 years; females 11 to 13 years

Risk Factors

Genetics

No clear genetic predisposition to SCFE

Pathophysiology

  • Stress across the proximal femoral physis results in slippage of the femoral neck relative to the head.
  • Weakening of the perichondrial ring and physis have been implicated.
  • The femoral head maintains its position within the acetabulum, whereas the femoral neck displaces anteriorly and more commonly superolaterally (varus).
  • In some cases, the neck displaces inferomedially (valgus).

Etiology

  • Stress on the proximal femoral physis from increased body weight, femoral retroversion, or inclination of the physis
  • Abnormal bone metabolism secondary to endocrinopathy or renal disorders
  • Toxicity to the physis from prior radiation or chemotherapy

Commonly Associated Conditions

  • Obesity
  • Endocrine dysfunction
    • Hypothyroidism
    • Hypopituitarism
    • Hyperparathyroidism
  • Growth hormone replacement therapy
  • Pelvic radiotherapy
  • Renal osteodystrophy

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Citation

Cabana, Michael D., editor. "Slipped Capital Femoral Epiphysis." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617760/all/Slipped_Capital_Femoral_Epiphysis.
Slipped Capital Femoral Epiphysis. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617760/all/Slipped_Capital_Femoral_Epiphysis. Accessed April 23, 2019.
Slipped Capital Femoral Epiphysis. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617760/all/Slipped_Capital_Femoral_Epiphysis
Slipped Capital Femoral Epiphysis [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 23]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617760/all/Slipped_Capital_Femoral_Epiphysis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Slipped Capital Femoral Epiphysis ID - 617760 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617760/all/Slipped_Capital_Femoral_Epiphysis PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -