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Slipped Capital Femoral Epiphysis

This diagnosis occurs most commonly in boys between the ages of 10 and 17 who are commonly obese. Although typically of unknown cause, it has been associated with hormone abnormalities. 10 – 25% of cases are bilateral and trauma is associated with approximately 25% of cases. To make the diagnosis, X-rays typically are performed.

Signs and Symptoms
Groin pain may develop slowly or come on suddenly. The hip pain may extend to the knee or anterior thigh. Limited motion of the hip usually is present, with the leg being more comfortable in external rotation. Early in the process, plain films may reveal widening of the growth plate. More advanced changes result in slippage of the bone.

Differential Diagnosis
Other common causes of hip pain in this young patient population include muscle strain, avulsion fracture, or growth plate injuries in other areas around the hip.

Management
Surgical treatment consists of fixation when it presents initially. If symptoms occur later in life in patient who have been treated for this condition, the symptoms may be due to femoroacetabular impingement.

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