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Slipped capital femoral epiphysis
Definition
A slipped capital femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone.
Alternative Names
Femoral epiphysis - slipped
Causes
A slipped capital femoral epiphysis may affect both hips.
An epiphysis is an area at the end of a long bone that is separated from the main part of the bone by the growth plate. In this condition, the problem occurs in the upper area while the bone is still growing.
Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. It is more common in:
- Growing children ages 11 to 15, especially boys
- Children who are obese
- Children who are growing rapidly
Children with hormone imbalances caused by other conditions are at particular risk for this disorder.
Symptoms
- Difficulty walking, walking with a limp
- Knee pain
- Hip pain
- Hip stiffness
- Outward-turning leg
- Restricted hip movements
Exams and Tests
The doctor or nurse will examine you. A hip or pelvis x-ray can confirm this condition.
Treatment
Surgery to stabilize the bone with pins or screws will prevent the ball of the hip joint from slipping or moving out of place. Some surgeons may suggest using pins on the other hip at the same time, because many children will develop this problem in that hip later.
Outlook (Prognosis)
The outcome is usually good with treatment. However, in rare cases, the hip joint may wear away, despite prompt diagnosis and treatment.
Possible Complications
This disorder is associated with a greater risk of osteoarthritis later in life. Other potential but rare complications include reduced blood flow to the hip joint and wearing away of hip joint tissue.
When to Contact a Medical Professional
If your child has persistent pain or other symptoms of this disorder, have the child lie down immediately and remain still until you get medical help.
Prevention
Weight control for obese children may be helpful. Many cases are not preventable.
References
Sankar WN, Horn BD, Wells L, Dormans JP. Slipped Capital Femoral Ephiphysis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 670.4.
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
