Damaged Growth Plate That Affects the Hip

Slipped capital femoral epiphysis (SCFE) is the most common condition affecting the adolescent hip. SCFE is most often seen in children from 11 to 14 years old. The hip is a ball and socket joint. In the growing child, the ball portion is called the epiphysis, which rests on a layer of cartilage called a growth plate, at the upper end of the femur (thigh bone). SCFE occurs when the growth plate at the upper end of the femur loosens, causing the femur to rotate and the epiphysis to “slip,” similar to the way ice cream might slide off a cone. Typically, the condition develops over weeks or months and causes increasing limping and pain with activity. Overweight or obesity is commonly associated with the condition, although it can also occur in normal weight children. Left alone, the condition may steadily worsen as the bone deformity increases.

Symptoms, Diagnosis and Outlook

The symptoms of SCFE include:

  • Limping or a lurching gait
  • Pain in the hip, groin or knee
  • Affected leg turning outward when walking

There are two main types of SCFE:

  1. Stable SCFE - child can still walk on the affected leg.
  2. Unstable SCFE - child cannot walk. This is an emergency, so the child needs to go to the hospital Emergency Department right away.

To diagnose SCFE, the doctor will ask about the child's medical history, perform a physical exam and check the hip area for pain and mobility. The doctor may also order X-rays.

Surgery is required to treat SCFE. A screw is inserted into the bone in order to hold the epiphysis in place and prevent worsening of the deformity. Once healed, children with a stable SCFE can usually expect to return to their normal activities and sports. Those with unstable SCFE are more likely to experience difficulties, and the outcomes are less predictable.

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