Classic Slipped Capital Femoral Epiphysis: A Case Report
Every emergency physician should be familiar with the problem of slipped capital femoral epiphysis (SCFE). The classic problem of adolescent hip/thigh pain is explored in this case and a subtle example of SCFE is presented. Radiologic findings are discussed that allow an astute clinician to make the diagnosis early in the disease course which allows the best patient outcomes possible.
A stable SCFE (one in which the patient can bear weight) has a much better prognosis than an unstable SCFE (one in which the patient cannot bear weight). The emergency physician should make the diagnosis as early in the disease process as possible, preferably while the SCFE is still stable. Once the diagnosis is made, the patient should be made non-weightbearing, and consultation with an orthopedic surgeon is necessary. Very frequently the patient is admitted to the hospital and meets the orthopedic surgeon to effectuate a definitive plan. Knowing the subtle history, age group, early X-ray findings, and making an early diagnosis will go a long way toward helping a patient with SCFE.
Slipped capital femoral epiphysis, adolescent hip problem, orthopedics, Klein’s line.