What is slipped capital femoral epiphysis in children?

Slipped capital femoral epiphysis (SCFE) is a condition of the hip joint that affects children. In SCFE, the ball of the thighbone (femoral head) slips off the neck of the thighbone. SCFE is often described as being like a scoop of ice cream slipping off the top of a cone. It can affect one or both hips.

What causes SCFE in a child?

The cause of SCFE is not known. It can occur suddenly after an injury, such as a fall. But it most often happens over a long period of time. SCFE tends to develop during short periods of rapid growth after the start of puberty.

Which children are at risk for SCFE?

SCFE is an unusual condition that is more likely to happen in children who are 10 to 16 years old. Other risk factors that increase the chance of SCFE are:

• Obesity

• Medicines, such as steroids

• Problems with the endocrine system, such as thyroid or growth hormone disorders

• Radiation treatment

• Bone problems linked to kidney disease

• Genetic disorders, such as Down syndrome

What are the symptoms of SCFE in a child?

Children with SCFE may have:

• Pain in the hip that gets worse with activity

• A limp

• Pain in the groin, thigh, or knee

• An outward-turned leg when they walk

These symptoms may start suddenly or develop over time. They may seem like other health problems of the hip. Make sure your child sees a healthcare provider for a diagnosis.

How is SCFE diagnosed in a child?

Your child’s healthcare provider will be able to diagnose SCFE after reviewing your child's health history and doing a physical exam. Your child may also need X-rays.

An early diagnosis of SCFE is important to help prevent a hip deformity. Once diagnosed with SCFE, your child may be told not to bear weight on the hip. They may need crutches or a wheelchair.

How is SCFE treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is.

The goal of treatment is to prevent the femoral head from slipping further off the thighbone. Treatment may include:

• Surgery. This treatment may involve the use of a steel pin or screw to hold the femoral head onto the thighbone to stop it from slipping further.

• Physical therapy. After surgery, physical therapy can help build up the hip and leg muscles.

Children with severe cases of SCFE are more likely to have limited hip motion, differences in leg lengths, and other hip problems in adulthood. But with early detection and correct treatment, a good outcome with few problems is possible.

Key points about SCFE in children

• SCFE is a condition of the hip joint that affects children. The femoral head slips off the neck of the thighbone.

• SCFE causes hip pain that gets worse with activity. Your child may also have a limp or walk with the leg turned outward.

• An exam and X-rays can help diagnose SCFE.

• Treatment includes surgery and physical therapy.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.