Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting early adolescents with an incidence of 0.2 (Japan) to 10 (United States) per 100,000. In this condition, the ball of the hip joint slips from the femur at the upper growing end (growth plate) of the bone. Most patients with SCFE develop limping and experience pain in the hip. SCFE is classified as stable when the patient can walk, and unstable when the patient is unable to walk even with the aid of crutches. There are two serious complications of SCFE that may occur immediately after the condition develops. One complication is chondrolysis cartilage necrosis, a condition where the articular cartilage of the hip joint is destroyed. The second and most severe complication of SCFE is avascular necrosis which is more common in patients with unstable SCFE. This condition usually occurs when the blood vessels that provide blood to the epiphysis are damaged. Patients also gradually develop arthritis in the hip joint (osteoarthritis). Treatment for SCFE aims to prevent further slippage, achieve closure of the physeal plate, and avoid complications.
The etiology of SCFE is still unknown, but it appears to be a multifactorial disorder with genetic, environmental (particularly mechanical), and hormonal factors in play. Several studies have found an association between Human Leucocyte Antigen (HLA) types A2, A11, B11, B12, B35, DR4, DR52 and SCFE in identical twins as well as unrelated patients.