Is slipped capital femoral epiphysis an emergency?

Is slipped capital femoral epiphysis 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.

What are the characteristics of a slipped capital femoral epiphysis?

In the more severe unstable SCFE, in which the femoral head has shifted abruptly, symptoms may include: Sudden onset of pain, often after a fall or injury. Inability to put weight on the affected leg. Outward turning (external rotation) of the affected leg.

What radiographs are appropriate to work up a patient with a slipped capital femoral epiphysis?

Standard radiography is the first-choice imaging modality in patients with suspected SCFE. Usually, anteroposterior (AP) pelvis and frog-lateral views of both hips are obtained (Fig. 1). Radiographs of the contralateral side should always be included to rule out the bilateral involvement of SCFE.

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.

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.

How is slipped epiphysis treated?

SCFE is always treated with surgery to stabilize the growth plate that slipped. But even before the surgery, the doctor will try to prevent any further slipping by encouraging rest and the use of crutches to avoid putting weight on the affected leg.

What is the best evidence for the treatment of slipped capital femoral epiphysis?

Conclusions: A systematic review of the literature recommends on the basis of level of evidence that the best treatment for a stable SCFE is single screw in situ fixation and for unstable SCFEs urgent gentle reduction, decompression, and internal fixation.

Who gets SCFE?

Typically, SCFE occurs in overweight children between 11 and 16 years old and is more common in boys than girls. SCFE occurs more frequently in African Americans and Hispanic children than Caucasians. It is also more likely to occur in children going through rapid growth spurts.

What does slipped capital femoral epiphysis mean?

What is slipped capital femoral epiphysis? Slipped capital femoral epiphysis (SCFE) a disorder of adolescents in which the growth plate is damaged and the femoral head moves (“slips”) with respect to the rest of the femur. The head of the femur stays in the cup of the hip joint while the rest of the femur is shifted.

What does it mean when your femur slips off your neck?

Slipped capital femoral epiphysis (SCFE) is a hip condition that occurs in teens and pre-teens who are still growing. For reasons that are not well understood, the ball at the head of the femur (thighbone) slips off the neck of the bone in a backwards direction.

Where is the long axis of the femoral neck?

The long axis of the femoral neck (red line) is anterior to the femoral head. Slipped capital femoral epiphysis. Slipped capital femoral epiphysis (SCFE) is a Salter-Harris type1 fracture through the proximal femoral physis and is the most common adolescent hip disorder.

Do you need ultrasound for slipped femoral metaphysis?

Alignment of the epiphysis with respect to the femoral metaphysis can be used to grade the degree of slippage: see SUFE grading. Ultrasound may be performed in the assessment of hip pain. However, it should not be used as a replacement for a pelvic radiograph.

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