Slipped capital femoral epiphysis

Slipped capital femoral epiphysis (SCFE) is one of the most frequent hip disorders in adolescents. In cases of delayed diagnosis and therapy, severe and evitable complications might occur. This article outlines diagnostic tools and therapy strategies for SCFE. With an open proximal femoral physis the metaphysis displaces anterolaterally from the proximal femoral epiphysis. Concerning etiology, several biomechanical, biochemical and genetic factors are under investigation. The clinical presentation ranges from a sudden inability to stand and walk to a complete lack of symptoms. In many cases mild and unspecific knee pain is the only symptom. The classification of SCFE can be temporal (e.g. acute, acute on chronic and chronic), clinical (e.g. stable and unstable) and radio-morphological (e.g. mild, moderate, and severe). Short-term sequelae are avascular necrosis of the epiphysis or chondrolysis, medium and long-term sequelae are femoroacetabular impingement (FAI) and osteoarthritis of the hip joint. The contralateral side is affected in 60-80 % of cases and is usually treated prophylactically at least in Europe.