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Slipped Capital Femoral Epiphysis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Femoral epiphysis translates (slips) posteriorly and inferiorly relative to the femoral head/neck

  • Classification systems:

    • Degree of femoral head “slip” as a percentage of femoral neck ...

Diagnosis

Signs and Symptoms

History

  • Determine chronicity of symptoms and whether or not the patient can bear weight

  • Pain in the knee, thigh, groin, or hip (referred pain from the obturator nerve):

    • Vague ...

Treatment

Pre-Hospital

Patient should be immobilized for transport, as with suspected hip fracture or dislocation. 

Initial Stabilization/Therapy

  • Immobilize hip; keep nonweight bearing

  • Do not attempt redu...

Follow-Up

Disposition

Admission Criteria

  • Acute, acute on chronic and bilateral SCFE requires orthopedic admission for urgent operative fixation (usually insitu single cannulated screw fixation)

  • Chronic S...

Pearls and Pitfalls

  • Klein line can be a helpful tool in picking up the abnormality on plain radiograph

  • Remember to examine the hip when a child presents with knee or thigh pain

Additional Reading

  • Aronsson  DD, Loder  RT, Breur  GJ, et al. Slipped capital femoral epiphysis: Current concepts. J Am Acad Orthop Surg.  2006;14(12):666–679.

  • Gholve  PA, Cameron  DB, Millis  MB....

Codes

ICD9

  • 732.2 Nontraumatic slipped upper femoral epiphysis

  • 732.9 Unspecified osteochondropathy

ICD10

  • M93.003 Unspecified slipped upper femoral epiphysis (nontraumatic), unspecified hip

  • M93.013 Acute sli...

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