Slipped Capital Femoral Epiphysis
Slipped capital femoral epiphysis (SCFE) is an unusual disorder of the hip where the ball at the upper end of the thigh bone (femur) slips in a backward direction. This is caused due to weakness of the growth plate. This condition is commonly caused during accelerated growth periods such as the onset of puberty.
The cause of SCFE is unknown. However in most cases it may be due to being overweight or from minor falls or trauma. Slippage of the epiphysis (ball at the upper and of the thigh bone) is a gradual and slow process, however it may occur suddenly in cases of trauma or falls.
The typical symptoms of SCFE include several weeks or months of hip or knee pain and limping. The affected leg may be turned outwards in comparison to the normal leg and may appear shorter.
SCFE is usually diagnosed with a physical examination, as it shows any abnormality in motion of the hip, gait and walking pattern. An X-ray of the hip will confirm the diagnosis as it shows any anatomical differences in the alignment of the hip bone.
Early diagnosis of SCFE gives a chance to achieve the treatment goal of stabilizing the hip. The treatment is mostly in the form of surgery which prevents any additional slipping of the femoral head until growth stops. Depending on the severity of the condition, your doctor will recommend one of these 3 surgical procedures:
- Placing a single screw in the thigh bone and the epiphysis
- Reducing the displacement of the femoral head and placing screws to hold it in place.
- Removing the abnormal growth plate and avoiding any further displacement with the help of screws.
Irritable hip, also known as acute transient synovitis, is a common disorder of childhood characterized by onset of hip pain and limping. The term transient means that it does not usually last long. It usually occurs before puberty and affects only one hip. Boys aged between 4 to 10 years are most often affected 2 to 4 times more than girls.
A child with irritable hip will experience the following symptoms:
- Hip pain
- Pain may spread to the groin, thigh, and knee areas
- Abnormal crawling
- Abnormal crying
- A slight fever
The exact cause of irritable hip is unknown. But in some cases, the condition can occur as a result of viral infection (upper respiratory tract) or a fall or injury. Irritable hip can also occur as a result of Perthes disease, a condition where the head of the thigh bone deteriorates because of poor blood supply.
The diagnosis of irritable hip is made based on your child’s symptoms and physical examination. To rule out other possible causes of your child’s symptoms, the following diagnostic tests may be ordered:
- X-rays: To detect any problem with your child’s bone
- Blood tests: To determine a bone or joint infection
- An ultrasound scan: It creates an image of the affected hip joint and detects any fluid on the joint
The treatment of irritable hip includes medications and bed rest. Painkillers or anti-inflammatory drugs (called NSAIDS) are prescribed to help relieve pain and reduce inflammation. Your doctor may prescribe some specific medications depending on the type of infection detected in the child. Applying heat and massaging the affected hip may also help in reducing hip pain.
Swimming is a great exercise to strengthen and regain the movement of the hip joint.