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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 . It 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.
Long bone
Long bones are hard, dense bones that provide strength, structure, and mobility. The thigh bone (femur) is a long bone. A long bone has a shaft and...
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 higher risk for this disorder.
Symptoms
Symptoms include:
-
Difficulty walking
, walking with a limp
Difficulty walking
Walking abnormalities are unusual and uncontrollable walking patterns. They are usually due to diseases or injuries to the legs, feet, brain, spinal...
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Knee pain
Knee pain
Knee pain is a common symptom in people of all ages. It may start suddenly, often after an injury or exercise. Knee pain also may begin as a mild d...
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Hip pain
Hip pain
Hip pain involves any pain in or around the hip joint. You may not feel pain from your hip directly over the hip area. You may feel it in your groi...
Read Article Now Book Mark Article - Hip stiffness
- Outward-turning leg
- Restricted hip movements
Exams and Tests
The health care provider will examine you. A hip or pelvis x-ray can confirm this condition.
Pelvis x-ray
A pelvis x-ray is a picture of the bones around both the hips. The pelvis connects the legs to the body.
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. This is because many children will develop this problem in that hip later.
Outlook (Prognosis)
The outcome is most often good with treatment. In rare cases, the hip joint may wear away, despite prompt diagnosis and treatment.
Possible Complications
This disorder is linked to 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.
Osteoarthritis
Osteoarthritis (OA) is the most common joint disorder. It is due to aging and wear and tear on a joint.
When to Contact a Medical Professional
If your child has ongoing pain or other symptoms of this disorder, have the child lie down right away and stay 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. The hip. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 678.
Sawyer JR, Spence DD. Fractures and dislocations in children. In: Azar FM, Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 13th ed. Philadelphia, PA: Elsevier; 2017:chap 36.
Review Date: 12/9/2016
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
