Slipped Capital Femoral Epiphysis
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Slipped capital femoral epiphysis (SCFE) is displacement of the femoral head (epiphysis) relative to the femoral neck (metaphysis).
- Most common adolescent hip disorder
- Male > female (3:2)
- Up to 25% bilateral at presentation
- 20–40% have contralateral involvement at some point.
- 2 to 7 per 100,000
- Age of onset: males 13 to 15 years; females 11 to 13 years
No clear genetic predisposition to SCFE
- 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).
- 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
- Endocrine dysfunction
- Growth hormone replacement therapy
- Pelvic radiotherapy
- Renal osteodystrophy