Slipped capital femoral epiphysis

Slipped capital femoral epiphysis (SCFE) is the most common hip abnormality in adolescence and is a major cause of early osteoarthritis. A variety of clinical and radiographic staging methods are used and may help predict prognosis, Plain radiography remains the imaging modality of choice in the evaluation of patients with suspected SCFE, Subtle, early radiographic abnormalities include widening of the physis on the affected side, sometimes accompanied by demineralization; diminution of the femoral epiphysis; and the metaphyseal blanch (or blush) sign, an area of increased opacity in the proximal part of the affected metaphysis, With a mild slip, the anterior view of the hip demonstrates several secondary signs of SCFE, whereas a lateral view demonstrates the actual slip, Early and late complications such as hardware loosening or migration, chondrolysis, osteonecrosis, and osteoarthritis also affect overall prognosis and are not infrequent complications, Treatment consists of stabilization across the physis with placement of pins or screws, Knowledge of radiographic abnormalities associated with SCFE may allow prompt diagnosis and treatment, which are essential for optimizing the functional outcome for affected patients.