Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about slipped upper femoral epiphysis. And you can find written notes on this topic

at Zero to Finals.com slash SU-F-E or Sufi or in the orthopedic section of the Zero Definals Pediatrics book.

So let's get straight into it.

Slipped upper femoral epiphysis or Sufi is also known as slipped capital femoral epiphysis, or

SCFE.

The condition involves the head of the femur being displaced or slipping along the growth plate.

It's more common in boys and typically presents aged 8 to 15 years with an average age of 12 in boys.

It presents slightly earlier in females with an average age of 11 years. It's more

common in obese children. So how does it present? The typical exam presentation is an adolescent,

obese male undergoing a growth spurt. There may be a history of minor trauma that triggers the

onset of the symptoms.

Suspect slipped up a femoral epiphysis if the pain is disproportionate to the severity of

the trauma. The presenting symptoms can be vague, and these can be hip groin thigh or knee pain,

restricted range of hip movement, and a painful limp.

When examining the patient, they will prefer to keep the hip in external rotation.

They will have limited movement of the hip, particularly restricted internal rotation.

So how do we establish the diagnosis? Well the initial investigation of

choice in Sufi is an x-ray. Other investigations that can be helpful in establishing the diagnosis

are blood tests which are normally normal but you're particularly looking at the inflammatory

markers to exclude other causes.

A technetian bone scan, a CT scan or an MRI scan.

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