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    Slipped capital femoral epiphysis

    Femoral epiphysis - slipped

    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.

    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.

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      Self Care

        Review Date: 11/12/2012

        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.

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        St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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