Abstract
CASE HISTORY: The patient is a 15-year-old male who presented with left hip pain of approximately 2 weeks in duration. The patient reported that the pain worsened with hip movement. He also described intermittent popping in the hip and pain radiating to the lateral thigh. The pain began before he fell and struck his hip 3 days ago. Despite using ibuprofen and Tylenol, the pain persisted with minimal relief. PHYSICAL EXAM: The patient appeared well-developed and well-nourished with no apparent distress. Musculoskeletal exam revealed pain with full flexion and external rotation of the left hip, but muscle strength and tone were normal with full range of motion in all extremities. The patient was oriented and had an appropriate affect. DIFFERENTIAL DIAGNOSES: Slipped capital femoral epiphysis (SCFE), juvenile idiopathic arthritis, avascular necrosis, femoral acetabular impingement, hip labral tear. TESTS & RESULTS: X-rays of the left hip were ordered and initially returned normal. An MRI of the left hip without contrast later revealed a moderate, stable slipped capital femoral epiphysis with bone marrow edema in the left femur, indicative of potential CAM-type femoral acetabular impingement. No avascular necrosis or hip labral injury was noted. FINAL DIAGNOSIS: Slipped capital femoral epiphysis (SCFE) of the left hip. DISCUSSION: SCFE is a condition where the femoral head slips off the neck of the femur, typically seen in adolescent males. It is often associated with hip pain, limited range of motion, and, in some cases, leg length discrepancy. This patient’s presentation, combined with MRI findings, is consistent with SCFE. Treatment typically involves surgical fixation to prevent further slippage and complications such as avascular necrosis or chondrolysis. OUTCOME OF THE CASE: The patient underwent surgery for in situ screw fixation of the left hip. The procedure was performed under general anesthesia with fluoroscopic guidance, and the screw was placed to stabilize the femoral head. There were no complications during the procedure, and the patient tolerated the surgery well. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: The patient was instructed to limit weight-bearing on the left lower extremity with crutches, walker, or wheelchair for 3-5 days. Dressings were to be kept for 3-5 days before being removed. The patient was advised to follow up in two weeks for a wound check and radiographs to assess the healing process.
Recommended Citation
Edwards, Isaac T.; Edwards, Lucas M.; and Willis, Kent
(2025)
"Case Presentation for Slipped Capital Femoral Epiphysis (SCFE),"
International Journal of Exercise Science: Conference Proceedings: Vol. 2:
Iss.
17, Article 151.
Available at:
https://digitalcommons.wku.edu/ijesab/vol2/iss17/151
Included in
Health and Physical Education Commons, Medical Education Commons, Sports Sciences Commons
