"Hip Pain in Teens"-Issue 4

"What is Slipped Capital Femoral Epiphysis?"
       To understand SCFE, you first have to know a little bit about the hip joint. As you can see pictured to the right, the hip joint consists of the rounded “ball” shaped end of the thigh bone, called the femoral head, and the “socket” shaped hole of the hip bone. In growing kids and teens, the growth center/growth plate is located just under the “ball” portion of the thigh bone, which is pictured in red.
        The job of this particular growth center is to keep the femoral head connected to the thigh bone while still allowing the bone to lengthen and grow. As discussed in our previous blogs, the growth center is made up of a soft cartilage, which is weaker than the bone, making it more susceptible to injury.
       Slipped capital femoral epiphysis (SCFE) occurs when the “ball” portion of the thigh bone slips out of place. In mild cases of SCFE a child may experience groin pain, knee pain, hip stiffness and a noticeable limp. In more severe cases, a child may have significant loss of motion in the affected leg, difficulty walking, significant pain, and an outward turned leg. The reason why this injury occurs is misunderstood. It often begins seemingly for no reason with no injury to associate with the pain.

       SCFE typically affects kids ages 11 to 16 and is much more common in boys. Several other factors can contribute to a child’s chances for developing SCFE including: family history of SCFE, kidney failure, endocrine disorders and being overweight.

      Catching SCFE early can make a big difference in how easily it can be treated. The longer a child walks on the unstable joint, the greater the chance that more slipping will occur. In cases of severe slippage, blood flow to the thigh bone may be impaired, requiring immediate medical attention.

      A child suspected of having SCFE will need to be evaluated by a trained orthopedic physician, and an x-ray should ALWAYS be requested. Often times a child will be misdiagnosed with a “muscle strain”, resulting in wasted time and placing the child at greater risk. An x-ray is of utmost importance to ensure an accurate diagnosis.
     SCFE is typically treated with surgery to stabilize the hip joint and prevent further slippage. When SCFE is detected and treated early, most kids do very well. They will likely receive physical therapy to strengthen the hip and leg muscles after surgery and will continue to have follow-up x-rays to monitor the condition.
      There is no guaranteed protocol to prevent SCFE. Parents can reduce the risk by encouraging kids to keep their weight within a healthy range. Maintaining a healthy weight can spare a child’s bones and joints from excess wear and tear that can weakens and damages them.
      If you would like more details about this condition please contact your physician or physical therapist for more information.

References:

1. http://www.seattlechildrens.org/

2. http://www.kidshealth.org/