Slipped Capital Femoral Epiphysis

Basics

Description

  • Slipped capital femoral epiphysis (SCFE) is displacement of the epiphysis of the head of the femur.

Epidemiology

  • Males > females (3:2)
  • Left hip twice as often as right, 25% bilateral
  • Associated with obesity, increased height, genital underdevelopment, pituitary tumors, growth hormone therapy

Incidence

  • 1–5 per 100,000
  • Age of onset: boys, 14–16 years; girls, 11–13 years (essentially, premenarche)

Risk Factors

Genetics

5% of children affected have a parent with SCFE.

Pathophysiology

  • Unclear: abnormal stress on normal physeal plate versus a process that weakens the plate
  • The femoral head slips posteriorly and inferiorly, exposing the anterior and superior aspects of the metaphysis of the femoral neck.

Commonly Associated Conditions

  • Obesity
  • Endocrine dysfunction
  • Primary hypothyroidism
  • Pituitary dysfunction
  • Hypogonadism
  • Cryptorchidism
  • Chemotherapy
  • Pelvic radiotherapy
  • Renal rickets

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