Slipped capital femoral epiphysis (SCFE) is the most common hip disorder seen in adolescents and it affects 1 in every 10,000 children in the United States.
Although its cause is unknown, SCFE may be related to
The disorder occurs 2 to 3 times more in males than females, and affects both hips 40% of the time.
Our senior physiotherapists can help with
We also can help with a wellness program to diminish or prevent arthritic changes in the hip later in life.
Slipped capital femoral epiphysis refers to a painful hip disorder that involves
Growth plates are made of cartilage, which is a weaker substance than bone. Once the head of the femur slips through the growth plate, or its relationship to the growth plate is compromised, the diagnosis of SCFE is highly likely and certain.
Symptoms associated with SCFE include:
The most common symptom of SCFE is limping.
Pain is typically observed around the hip, upper thigh, or inner knee. Hip pain is also frequently perceived in the groin or knee area. Motion at the hip is increased when pointing the foot outward (external rotation), but limited and painful when turning the foot inward (internal rotation). Muscle strength at the affected hip also is decreased.
As SCFE progresses and inflammation and pain are present, the ability to perform everyday activities decreases, and the child may refuse to put weight on the affected leg and will decrease the use of the affected hip and leg.
Children with SCFE are typically male adolescents, aged 10 to 15 years, who are experiencing a growth spurt. The disorder usually begins with involvement of a single hip. In some cases, slippage of the second hip may occur 6 to 12 months later, even if the child has undergone treatment for the first hip.
Unfortunately, a child’s symptoms may disappear for periods of up to 2 to 3 weeks. This pattern of pain and limping followed by no pain and no limping promotes uncertainty that a problem exists, and may cause the family to dismiss the urgency of the original symptoms.
Children with symptoms should be seen by our senior physiotherapists or health care provider as soon as possible.
A medical specialist, such as a pediatric orthopedic surgeon, is often the one to formally diagnosis SCFE. Our senior physical therapist also may be one of the first professionals to observe symptoms and make a referral to a specialist.
A diagnosis of SCFE is based on
Although the disorder is typically confirmed with radiographs, an MRI or CT scan may be necessary to ensure an accurate diagnosis.
A diagnosis of SCFE will fall under 1 of 2 categories:
Type #1: A stable condition is characterized by a mild slip of the head of the femur. A child is usually able to walk or use crutches for longer distances.
Pain and joint stiffness may be present in the affected lower
extremity, and a limp is usually observed. Rest often relieves the pain,
but pain can easily return with activity.
Type #2: A significant slip of the head of the femur creates an unstable and serious condition. Immediate treatment is necessary to protect the tissues around the hip joint.
An unstable condition is associated with a difficulty or inability to walk. The child likely will refuse to walk on the affected leg, even when offered an assistive device, such as a crutch or walker.
Our hip joint is our body’s strongest and most stable joint.
Any disability in the hip joint should always be examined as quickly as possible. Our senior physiotherapists may be one of the first health care professionals to
Evaluation is very important for guiding the treatment of SCFE.
We will conduct a thorough evaluation that includes
We work closely with each child and their caregivers to develop an individualized treatment program, and promote a return to full mobility.
We will work with you and your child to ensure the safe performance of daily activities, and recommend temporary movement restrictions in the child’s best interest.
Treatment for slipped capital femoral epiphysis includes keeping the head of the femur stable, and maintaining lower-extremity range of motion and strength in order to prevent the development of arthritic conditions in the future.
Often, surgery is required to stabilize the bone and promote healing.
After the initial diagnosis, a child may use crutches until the time of surgery, in order to protect the site until joint alignment is restored.
After surgery, a follow up with the orthopedic surgeon is necessary to establish recovery and treatment guidelines. Physical therapy will begin after surgery in order to promote strengthening and return to activity.