en españolDeslizamiento de la epífisis capital femoral (SCFE, o epifisiolisis). A good, stable connection at the hip joint is what lets us walk, run, jump, and many . En algunos niños, particularmente en los que son obesos, el hueso del muslo y el de la cadera no están conectados como deberían debido a una afección. Slipped upper femoral epiphysis (SUFE), also known as a slipped capital femoral epiphysis (SCFE), is a relatively common condition affecting the physis of the.
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A good, stable feomral at your hip joint epifisioljsis what lets you walk, run, make that jump shot, and shake it on the dance floor. But in some teens — particularly those who are obese — the thighbone and the hipbone are a little less well connected than they should be because of a epiisiolisis called slipped capital femoral epiphysis SCFE. Though the name’s quite a mouthful, it simply refers to a shift at the upper part of the thighbone, or femur, that results in a weakened hip joint.
Fortunately, when recognized early, most femoarl of SCFE can be treated successfully. To understand SCFE, it helps to know a little about the hip joint. The hip is a ball-and-socket joint, which means that the rounded end of one bone in this case, the “ball” of the thighbone fits into the hollow of another bone the pelvis. Ball-and-socket joints offer the greatest range of movement of all types of joints, which is why you can move your legs forward, backward, and all around.
Kids and teens also have a growth plate at the top of the thighbone femurjust under the epifisillisis portion of the joint. This is called the physis, and it’s made out of cartilage, which is weaker than bone. The job of the physis is to connect the femoral head the “ball” to the femur while still allowing the bone to lengthen and grow. In SCFE, the “ball” called the epiphysis slips off of the top part of the femur, almost the way a scoop of ice cream might slip off a cone. Sometimes femkral happens suddenly — after a fall or sports injury, for example.
Slipped Capital Femoral Epiphysis (SCFE)
eepifisiolisis But it can also happen gradually, with no previous injury. A stable SCFE usually causes the person to limp and walk with the foot turned outward. The pain and the limp typically tend to come and go, worsening with activity and getting better with rest. Because of the direction of the slipped epiphysis, the person’s foot and leg will turn outward just like in a stable SCFE. An unstable SCFE is very serious because it can restrict blood flow to the hip joint.
Sometimes SCFE can irritate the nerves that run down the leg so the person thinks the pain is coming from the knee. This type of pain is called referred painwhich means pain starts epifisiooisis one part of the body but is felt in another part. In this case, pain begins in the affected hip joint but is felt in the normal knee joint.
No one knows for sure what causes SCFE. Doctors do know SCFE mostly happens in people between the ages of 11 and 16 who are going through a growth spurt. SCFE is more common in guys, though girls can have it too.
SCFE is also more likely to happen to teens who have specific stuff going on fekoral their health, such as:. If a doctor thinks you may have SCFE you’ll need to see an orthopedic doctor a doctor who specializes in the treatment of boneswho will do a physical exam, checking the range of motion of the hips and legs and seeing if there is any pain.
The doctor will also take X-rays of the hip to look for the displacement at the head of the thighbone. In rare cases, the X-rays will come back normal, but the pain, stiffness, and other problems will still be there.
In these cases, a magnetic resonance imaging study MRI might be ordered. SCFE is always treated with surgery to stabilize the growth plate that slipped.
Slipped upper femoral epiphysis | Radiology Reference Article |
Many doctors recommend admission to the hospital as soon as the SCFE is discovered to make sure the patient rests, and so surgery can be done as soon as possible. Surgery for SCFE is done under general anesthesia when a patient is completely asleep.
Using a fluoroscope — a special X-ray machine that produces a real-time image of the hip on a TV screen — as a guide, the surgeon makes a tiny incision near the hip, then puts a metal screw through the bone and across the growth plate to hold it in place.
The screw is placed deep into the bone, and can’t be felt by patients after surgery. Because some patients have a high risk of an SCFE in the other hip, the surgeon might also stabilize that side too, even if it hasn’t slipped yet.
Doctors decide how much weight can be placed on the affected leg after surgery based on the severity of the slip. Patients usually can walk with crutches, but those who have both hips treated may need to use a wheelchair for the first couple of weeks after surgery. Most teens whose SCFE is caught and treated early do well. Doctors will continue to order follow-up X-rays to monitor the condition. In the majority of cases, further surgery is not needed.
Slipped capital femoral epiphysis
However, teens with unstable SCFE have a greater chance of developing other problems later, like stiff hips, early arthritis, leg length differences, or avascular necrosis where part of the “ball” dies from lack of blood supply. They’re also more likely to require additional surgery to take care of the hip.
Not everyone can prevent SCFE. But one thing you can do to lessen your risk is to keep your weight in a healthy range. Maintaining a healthy weight can go a long way in sparing your bones and joints from the excess wear and tear that can weaken and damage them.
So if you need help figuring out how to start on a safe diet and exercise plan, talk to your doctor.
All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Slipped Capital Femoral Epiphysis (SCFE) – Pediatrics – Orthobullets
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