Clinical features

Initial presentation is with vague symptoms. In some patients absence of symptoms in the hip may cause missed or a delay in the diagnosis (1).

Presenting features of SCFE include:

• limping
• pain, which can be poorly localized to the hip, groin, thigh, or knee
  • in 15% of cases knee or distal thigh pain is the presenting feature (2)
• pain on movement
• reduced range of movement (internal rotation) of the hip support the diagnosis of SCFE (2)
• the affected leg is externally rotated and shortened (compared to the contralateral side) (3)
• external rotation becomes gross when the hip is passively flexed to 90 degrees (2)

Note:

• examination of both the hips are important since there is a possibility that the condition may be bilateral (3)

Reference:

• (1) Uglow MG, Clarke NM. The management of slipped capital femoral epiphysis. J Bone Joint Surg Br. 2004 Jul;86(5):631-5.
• (2) Peck D. Slipped capital femoral epiphysis: diagnosis and management. Am Fam Physician. 2010;82(3):258-62.
• (3) Mashru RP et al. Knee pain in a 12 year old girl. Hospital Physician 2006:42(6)