Summary about Disease
Slipped Capital Femoral Epiphysis (SCFE) is a hip condition that occurs in adolescents, where the ball (femoral head) at the upper end of the thighbone (femur) slips off the neck of the femur at the growth plate. This results in pain, stiffness, and altered gait. It's most common during the growth spurt years, and can affect one or both hips.
Symptoms
Hip, groin, thigh, or knee pain (pain may be referred to the knee)
Limping (especially with an outward pointing of the foot)
Stiffness in the hip
Limited range of motion in the hip
Difficulty walking or bearing weight
Leg length difference (in some cases)
Causes
The exact cause is not fully understood, but likely involves a combination of factors:
Mechanical factors: Obesity, rapid growth spurts
Endocrine factors: Hormonal imbalances, such as hypothyroidism
Genetic factors: Although rare, there is some evidence of genetic predisposition.
Bone structure: Weakness in the growth plate.
Medicine Used
SCFE is primarily treated surgically, rather than with medication. Pain management may involve:
Over-the-counter pain relievers: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for mild pain before diagnosis.
Prescription pain medication: Stronger pain relievers might be prescribed after surgery for a short period.
Is Communicable
No, Slipped Capital Femoral Epiphysis is not a communicable disease. It is not caused by an infection and cannot be spread from person to person.
Precautions
Maintain a healthy weight: Obesity is a risk factor.
Early diagnosis and treatment: Seek medical attention promptly if a child experiences hip, groin, thigh, or knee pain, especially with a limp.
Follow-up care: Adhere to all post-operative instructions and attend follow-up appointments.
How long does an outbreak last?
SCFE is not an outbreak-related disease. It is a condition that develops individually in susceptible individuals. Therefore, the concept of an outbreak duration does not apply.
How is it diagnosed?
Physical Examination: Assessment of hip range of motion, gait, and pain location.
X-rays: AP (anteroposterior) and frog-leg lateral X-rays of the hip are the primary diagnostic tool.
MRI: May be used in early or subtle cases to visualize the growth plate and detect subtle slips.
Bone Scan: Rarely used
Timeline of Symptoms
The onset of symptoms can be gradual or sudden:
Acute SCFE: Sudden onset of severe pain and inability to bear weight (often associated with a recent injury).
Chronic SCFE: Gradual onset of mild pain, limping, and stiffness that worsens over weeks or months.
Acute-on-chronic SCFE: A chronic condition with a sudden worsening of symptoms.
Important Considerations
Early diagnosis is crucial: Prompt treatment can prevent further slippage and complications.
Surgery is often necessary: The goal of surgery is to stabilize the femoral head and prevent further slippage.
Non-weight bearing: After diagnosis, it is important to avoid weight bearing on the affected leg until surgery.
Long-term follow-up: Lifelong monitoring is recommended to check for complications such as avascular necrosis or osteoarthritis.
Contralateral Prophylactic Fixation: Because SCFE can occur in both hips, prophylactic fixation of the unaffected hip may be considered, especially in younger children or those with endocrine disorders.