1. The differential for pediatric acute hip pain includes:
Mechanical / Orthopedic
Neoplastic / Infiltrative
2. This x-ray demonstrates a slipped capital femoral epiphysis (SCFE) of the left femoral head.
Slipped capital femoral epiphysis (SCFE) is one of the most common developmental conditions of the pediatric hip. It usually affects teens and preteens.
SCFE is actually a fracture of the growth plate (physis) causing the femoral head to slip off the neck of the femur (the old “ice-cream falling off the cone” analogy).
Symptoms (including hip, groin, thigh or knee pain) may be present for weeks to months.
Childhood obesity is the single greatest risk factor.
3. The most common complication of SCFE is
Osteonecrosis of the femoral head.
Other complications include chondrolysis, residual proximal femoral deformity and limb length discrepancy, slip progression, hip stiffness, degenerative arthritis and pin associated proximal femur fracture.
4. Treatment for both stable and unstable slips is operative management with percutaneous in situ fixation or bilateral in situ fixation (if endocrine work-up is positive).