Slipped capital femoral epiphysis: Acute and chronic

Slipped capital femoral epiphysis (SCFE) involves displacement of the proximal femoral metaphysis relative to a fixed epiphysis, generally during a period of rapid growth and unique physeal susceptibility. Affected patients have characteristic clinical, histological, and radiologic features that contribute to the displacement. A number of concomitant clinical features and medical diagnoses should heighten a physician's suspicion of SCFE, prompting appropriate radiologic and laboratory workup. Limp and hip or knee pain in a patient between the ages of 10 and 16 should always include SCFE in the differential until proven otherwise. Once the diagnosis is made, appropriate treatment involves proximal femoral physeal stabilization by a number of surgical methods. The optimal surgical treatment of severe SCFE and its late sequelae remain an evolving and controversial subject.