Slipped Capital Femoral Epiphysis- SCFE


Slipped Capital Femoral Epiphysis(SCFE) is a disorder of the proximal femoral physis- the displacement of capital femoral epiphysis relative to the femoral neck

Clinical Features:

  • Age- 10-17 years
  • Sex- Male>Female
  • Obesity
  • Symptoms: Groin & Thigh Pain(MC); many children also have knee pain
    -presenting for weeks to months
  • Sign: -hip pain on movement & decreased/loss of hip motion
    -abnormal gait: coxalgic, externally rotaed or Trendelenburg gait
    -if prolonged: thigh muscle atrophy

Slipped Capital Femoral Epiphysis


  • PathoAnatomy- Expansion of hypertrophic zone with widening of physeal plate; Weakness/instability of the perichondral ring & abnormal cartilage maturation in the hypertrophic zone- a weak point
  • Mechanism– Changing of the orientation of proximal physis normally from horizontal to oblique during preadolescence & adolescence→ hip forces change from compression forces to shear forces
    -Slippage through the weakened area of hypertrophic zone by mechanical forces acting on susceptible physis.
  • Proximal epiphysis remains in the acetabulum; the distal part(neck): anterior displacement & external rotation