My 14-year-old son has been having recurrent pain in his right hip and knee. Although a little overweight, he is generally healthy and is actively involved in sports.
When our doctor examined him she said there may be a problem with his hip - something she called a slipped epiphysis - and has sent him for an X-ray. What could have caused this?
A slipped capital femoral epiphysis (SCFE) is the term used to describe a separation of the thighbone - the femur - at its growth plate in the hip joint. Although the cause is unknown, it tends to occur in adolescents who are overweight. The condition is more common in boys. It is thought that SCFE may results from a thickening in the area of bone where growth occurs or possibly as a result of changes in hormonal levels which occur at the time of puberty. If the separation is left untreated, the top of the thigh bone eventually loses its blood supply leading to it's decay and eventual collapse.
He does not complain too much about it. Surely for something that sounds so serious he should be in more pain?
Early symptoms usually include stiffness or low levels of pain in the hip. In some people the pain may seem to originate in the knee. The pain characteristically resolves with rest but worsens with activities that involve moving the hip such as walking or sports. If the problem is left untreated a limp can develop with the affected leg twisting outwards. At this point the pain in the hip is usually severe and extends down the inner thigh to the knee.
Will an X-ray show the problem up or will he need more extensive tests? And if SCFE is found to be the cause of his pain, how will it be treated?
An X-ray will usually detect any slippage or separation of the head of the femur from the shaft of the bone. Early diagnosis is important so the problem can be surgically corrected. This usually involves the separated ends of the femur being correctly aligned and attached together with metal pins. Immobilisation of the hip in a cast will be needed for a period of up to eight weeks until healing occurs. Physiotherapy may be recommended to improve muscle strength and mobility of the hip joint.
Marion Kerr