pediatrics
Slipped Capital Femoral Epiphysis (SCFE)
Symptoms and Signs of SCFE
Onset is usually insidious, and symptoms of slipped capital femoral epiphysis are associated with stage of slippage. The first symptom of SCFE may be hip stiffness that abates with rest; it is followed by a limp, then hip pain that radiates down the anteromedial thigh to the knee. Up to 15% of patients present with knee or thigh pain, and the true problem (hip) may be missed until slippage worsens. Early hip examination may detect neither pain nor limitation of movement. Up to 15% of patients with slipped capital femoral epiphysis present with knee or thigh pain, and the true problem (hip) may be missed until slippage worsens. In more advanced stages, findings may include pain during movement of the affected hip, with limited flexion, abduction, and medial rotation; knee pain without specific knee abnormalities; and a limp or Trendelenburg gait. The affected leg is externally rotated. If blood supply to the area is compromised, avascular necrosis and collapse of the epiphysis may occur. 