Aetiology

The aetiology is unclear and is thought to be multifactorial. It includes:

• obesity -
  • 63% of the children who are diagnosed with SCFE have a weight in the 90th percentile or higher
• growth surges
• endocrine disorders
  • less common
  • related disorders include - hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism
  • in patients with unusual presentations (e.g. - patients who are younger than eight years, older than 15 years, or underweight), an endocrine disorder should be considered as the cause of SCFE (1).

Note:

• trauma causes fracture in a different part of the bone, and it has been variously suggested that it may be caused by hormonal (hypothyroidism and treatment with growth hormone have been implicated (2))or calcification abnormalities.
• obese children with delayed secondary sexual development, or tall thin boys, appear particularly susceptible to this condition.

Reference:

1. Peck D. Slipped capital femoral epiphysis: diagnosis and management. Am Fam Physician. 2010;82(3):258-62.
2. GP magazine (26/1/04), 42