Slipped Capital Femoral Epiphysis

• fracture through the growthplate (physis) resulting in slippage of overlying end of femur (epiphysis)
• may report antecedent trivial trauma
• presentation: hip pain, groin pain, thigh pain, knee pain, limp &/or decreased range of motion of hip
• most common in obese adolescent males or tall, thin, rapidly growing 
• diagnosis:  AP & B/L frog leg lateral views
• treatment: operative internal fixation; consider prophylactic treatment of asymptomatic hip (bilateral in up to 40%)
• complications: avascular necrosis, degenerative arthritis, gait abnormalities, chronic pain

Image courtesy of Brian Freeze, MD

References

Rivers, Carol.  Orthopedic Emergencies.  In: Preparing for the Written Board Exam in Emergency Medicine.  7th ed.  Columbus, Ohio:  Ohio Chapter, American College of Emergency Physicians; 2014:  477.

Walter, K, Lin, Y, Schwartz, E.  Slipped Capital Femoral Epiphysis.  Medscape Website.  http://emedicine.medscape.com/article/91596-overview.  Updated Dec 2016.  Accessed July 18, 2017.