Slipped capital femoral epiphysis
 Discussion of Slipped capital femoral epiphysis
- Slipped capital femoral epiphysis (SCFE) is a Salter-Harris type 1 fracture through the proximal femoral physis.
- Unlike typical Salter-Harris type I fractures, SCFE has a high propensity for morbidity.
- Stress around the hip causes a shear force to be applied at the growth plate.
- The almost exclusive incidence of SCFE during the adolescent growth spurt indicates a hormonal role.
- Obesity is another key predisposing factor in the development of SCFE.
- Stress on the hip causes the epiphysis to move posteriorly and medially.
- Because the physis has yet to close, the blood supply to the epiphysis still should be derived from the femoral neck; however, this late in childhood, the supply is tenuous and frequently lost after the fracture occurs.
- Manipulation of the fracture frequently results in and chondrolysis because of the tenuous nature of the blood supply.
- Clinical presentation often is misleading, with only 50% of patients presenting with hip pain and 25% presenting with knee pain.
 Imaging Findings
- Salter-Harris type 1 fracture of the proximal femoral physis with posterior-medial displacement of the proximal femoral epiphysis.
Patient #1: Radiographs demonstrate left slipped capital femoral epiphysis
Patient #2: Radiographs demonstrate right slipped capital femoral epiphysis