Condition mainly affecting overweight pre‐pubertal adolescent boys where the femoral head epiphysis slips inferiorly in relation to the femoral neck

Aetiology

• Age 8-18
• Pubertal growth
• Overweight
• Mainly affects males (80% of cases)
• Racial differences - particularly affects Afro-Caribbean and Hispanic populations
• Endocrine/metabolic - hypothyroidism or renal disease may predispose to SUFE

Pathophysiology

• The growth plate (physis) is not strong enough to support body weight and the femoral epiphysis slips due to the strain
• A growth spurt may preclude the onset and puberty may be delayed (idiopathic or hypothyroidism)

Clinical features

• Cases can be acute, chronic or acute-on-chronic

Symptoms

• Hip, groin, thigh or knee pain with limp
  • Patients can present purely with pain in the knee (due to the obturator nerve supplying both the hip and knee joint) - make sure to examine the hip!
• 1/3 of cases are bilateral

Signs

• Antalgic gait
• Loss of internal rotation of the hip

Investigations