What is Slipped capital femoral epiphysis (SCFE)?

• A. Displacement of the capital femoral epiphysis through the growth plate.
• B. Fracture of the femoral neck.
• C. Dislocation of the acetabulum.
• D. Inflammation of the hip joint.

Answer: (A)

SCFE is when the head of the femur (the capital femoral epiphysis) slips downward and usually posteriorly through the growth plate. This occurs during adolescence when the growth plate is relatively weak, and it's often linked to rapid growth and obesity. The slip means the epiphysis remains attached to the acetabulum while the neck and shaft move away, so the hip appears painful with limp, and exam often shows limited internal rotation and a leg held in the manner of external rotation. X-rays reveal the displaced head relative to the neck, with signs such as a disrupted line along the femoral neck. This is distinct from a fracture of the femoral neck, which is a break in the bone itself; from a dislocation of the acetabulum, which is a joint dislocation; and from inflammatory hip arthritis, which involves joint inflammation rather than a mechanical slip through the growth plate. The defining feature is the slip of the capital femoral epiphysis through the growth plate, not a bone fracture, dislocation, or inflammatory process.