Slipped capital femoral epiphysis (SCFE)

What is SCFE?

Slipped capital femoral epiphysis, or SCFE, is a painful condition in the hip joint that occurs in children, usually between 10 and 15 years old.

The hip is a ball-and-socket joint. The ball is called the femoral head. The femoral head is connected to the top of the thigh bone by the growth plate.

In a child who has SCFE, the growth plate separates and causes the femoral head to slip from the normal position on the top of the thigh bone. The child feels pain because this slipping of the femoral head causes the thigh bone to push away from the hip, preventing the hip joint from moving properly.

SCFE can be caused by kidney failure, thyroid disorders, radiation therapy, obesity, or an injury to the hip. Sometimes the cause is not known. Adults who had SCFE as children have an increased chance of getting hip arthritis, which can lead to needing a hip replacement.

What are the symptoms of SCFE?

Children with SCFE feel pain in the groin, the thigh, or sometimes only the knee. They will often have a limp. They also may have stiffness in the hip and a limited range of motion, especially when trying to turn the leg inward.

Symptoms can appear gradually over weeks or months, but they may also appear suddenly, leaving the child unable to walk or get out of a chair or bed.

How is SCFE treated?

Mild SCFE can be treated with screws that hold the femoral head in place. This doesn’t correct the stiffness in the hip, but it prevents the femoral head from slipping farther. Later, the patient may have surgery to treat the stiffness and any damage in the joint. This can also reduce the chance of hip arthritis.

For more severe cases of SCFE, an approach called a modified-Dunn procedure can be used to correct the femoral head position so that the joint moves with better range of motion. This procedure can reduce the chance that the patient will get hip arthritis later in life.

In all cases of SCFE, proper treatment is necessary to help the patient avoid needing a hip replacement as an adult. Orthopedic surgeons at University of Iowa Stead Family Children’s Hospital have the expertise to treat SCFE.