Hip10 – 16 years
Slipped Capital Femoral Epiphysis (SCFE)
Displacement of the proximal femoral epiphysis relative to the metaphysis through the physis, most often in overweight adolescents.
Presentation
- Hip, thigh, or knee pain with limp
- Obligatory external rotation with hip flexion (Drehmann sign)
- Classified as stable vs unstable based on ability to bear weight
Imaging & Workup
- AP and frog-leg lateral pelvis — Klein line disrupted
- Evaluate for bilateral involvement and endocrine causes
Treatment
In situ screw fixation
Standard for stable slips to prevent progression.
Urgent stabilization
Unstable slips require prompt treatment; high AVN risk.
Clinical Pearls
- Always examine the contralateral hip
- Consider endocrine workup in atypical age or body habitus