Best Practice Case Studies-Pediatric Issues

Pdf Summary

In this case study, we explore slipped capital femoral epiphysis (SCFE), a common hip disorder in adolescents, characterized by the slippage of the femoral epiphysis on the metaphysis. SCFE typically occurs between ages 8 to 15 and is often associated with obesity and growth spurts, occasionally linked to endocrine abnormalities such as hypothyroidism. The provided cases illustrate different scenarios of SCFE in young adolescents presenting with hip pain.<br /><br />In the first case, a 12-year-old boy presents with groin, thigh, and knee pain post-football game with no specific injury; given his age and elevated BMI, SCFE is suspected. The correct imaging technique is AP and frog-leg bilateral hip x-rays since a significant percentage of SCFE patients experience bilateral issues.<br /><br />The second case involves a 13-year-old male Pacific Islander experiencing right hip pain after rugby. Diagnosis of stable SCFE leads to surgical fixation with a single screw, emphasizing non-weight-bearing immediately post-diagnosis to prevent further slippage.<br /><br />In the third scenario, a 13-year-old male presents with vague right leg pain and an antalgic gait. Diagnosing SCFE requires radiographs of both hips. This condition is most prevalent in adolescents mainly due to factors like obesity and growth spurts, distinguishing it from other hip pathologies such as septic arthritis, transient synovitis, and Legg Calve-Perthes disease.<br /><br />Management of SCFE includes non-weight-bearing instructions and may involve surgical intervention, depending on the case specifics. Preventive strategies may be considered for contralateral hip involvement when a high risk is noted. Each case underscores SCFE's potential for misdiagnosis and the importance of early recognition and appropriate management to avoid long-term complications.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 45

Topic Pediatric Issues

Keywords

slipped capital femoral epiphysis

SCFE

adolescents

hip disorder

obesity

growth spurts

endocrine abnormalities

surgical fixation

antalgic gait

radiographs

3rd Edition

3rd Edition, CASE 45

Pediatric Issues