Slipped Upper Femoral Epiphysis

Many children with a slipped epiphysis will complain of pain following sport which will be dismissed as a pulled muscle, or a strained ligament.

Doctors should suspect a slipped epiphysis if a limping adolescent complains of persisting pain in the knee, thigh, groin or hip, regardless of recent trauma or exertion.

Unfortunately, a slipped epiphysis can easily be missed on X-ray. An early SUFE can be difficult to spot as the signs are very subtle. 12% of cases are not diagnosed on an AP (anteroposterior) film. Lateral or "frog-leg" later X-rays may be more helpful in showing the widening of the epiphyseal line, or displacement of the femoral head.

If treated early then the prognosis for a slipped epiphysis is very good, but a delay in treatment can result in serious injury and a permanent limp.

If you or your child has suffered from a delay or mis-diagnosis of slipped upper femoral epiphysis you may be able to make a claim for compensation for your suffering.

Call us on 0800 054 6512 or contact us via the form on the right.

What is Slipped Upper Femoral Epiphysis (SUFE)?

Slipped upper femoral epiphysis or slipped capital femoral epiphysis is the commonest hip disorder in adolescence. It is 3 times as common in boys.

Risk factors include adolescents who are either obese or tall and thin following a growth spurt.

Slipped upper femoral epiphysis is a common cause of limping and leg pain in adolescents, and the symptoms should be taken seriously.

Prior to the slip the patient will often have slight discomfort.

The acute onset of SUFE presents with severe pain, to the extent that the child is unable to walk or stand.

In an acute or chronic presentation the child can be in pain with limp and altered gait, which can occur for several months suddenly becoming more painful.

With chronic presentation the child has mild symptoms, is still able to walk with an altered gait. A significant number of cases report knee pain as the only symptom.

If the condition is treated early, while the patient is still able to weight bear, there is a 96% chance of a good prognosis, but if it is more severe, and the leg is unable to bear weight, the chance of a good outcome reduces to 47%. There is also a 50% chance of a vascular necrosis in severe cases.

It is therefore important for a prompt diagnosis to be made.

As a rule of thumb, a doctor should suspect a slipped epiphysis every time he sees an adolescent, or pre-adolescent, complaining of pain in the knee, until proven otherwise.

Another cause of mis-diagnosis is the assumption that a limp, accompanied by pain in the groin, thigh or knee, is associated with injury.

Many children with a slipped epiphysis will complain of pain following sport, as a result of which the pain can be dismissed as a pulled muscle, or a strained ligament. Such injuries will usually resolve within a few weeks and are not generally associated with a persistent limp.

It has also been suggested that doctors should suspect a slipped epiphysis if a limping adolescent complains of persisting pain in the knee, the high, groin or hip, regardless of recent trauma or exertion.

Finally, a slipped epiphysis can be missed on X-ray. An early SUFE can be difficult to spot as the signs are very subtle. 12% of cases are not diagnosed on an AP (anteroposterior) film. Lateral or "frog-leg" later X-rays may be more helpful in showing the widening of the epiphyseal line, or displacement of the femoral head.

The Radiologist should look with special care for signs of slipped epiphysis if the patient's age and history are suspicious ie. an adolescent with limp and/or pain.

If treated early then the prognosis for a slipped epiphysis is very good, but a delay in treatment can have adverse outcomes. Surgical closure of the epiphysis usually occurs by inserting screws under the skin.

If you or a member of your family are suffering from Slipped Upper Femoral Epiphysis (SUFE) and are unhappy with the surgery or treatment you have received or believe the surgeon, doctor, nursing professionals or hospital has been clinically or medically negligent please contact our specialist clinical negligence team for confidential advice.

Please complete our online enquiry form and one of our specialists will contact you shortly or please contact us on 0800 054 6512.