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Slipped Capital Femoral Epiphysis (SCFE)


Frank Pessler

, MD, PhD, Helmholtz Centre for Infection Research

Reviewed/Revised Nov 2022
Topic Resources

Slipped capital femoral epiphysis is a slippage or separation of the end of the thighbone (femur) at its growth plate in the hip joint.

  • This disorder may be caused by a weakened growing hip joint.

  • Typical symptoms include stiffness or mild pain in the hip.

  • The diagnosis is based on x-rays and sometimes other imaging tests.

  • Surgery is usually needed to correct the disorder.

The femur is the thighbone. The capital femoral epiphysis is the head of the femur (the ball in the ball-and-socket of the hip joint). The epiphysis can slip off the end of the femur. The slipping occurs at the growth plate Overview of Bone Disorders in Children Bone disorders can be caused by injury, infection, or cancer, be inherited, occur as part of a child’s growth, or occur for no known reason. Some bone disorders can cause pain and difficulty... read more . Growth plates are soft areas of cartilage near the ends of bones from which children's bones grow.

Slipped capital femoral epiphysis usually develops in early adolescence and most commonly affects boys. Obesity Obesity in Adolescents Obesity is defined as a body mass index (BMI) equal to or greater than the 95th percentile for age and gender. Although genetics and some disorders cause obesity, most adolescent obesity results... read more is a major risk factor. Many children who develop this disorder in one hip eventually develop it in both hips.

Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis

Causes of SCFE

The cause of slipped capital femoral epiphysis is not known. However, the disorder most likely results from a weakening in the growth plate.

A weakening in the growth plate can result from injury, hip deformities, complications due to obesity, inflammation, or changes in levels of hormones in the blood (such as a low thyroid hormone level), which normally occur around puberty (see Puberty in Girls Puberty in Girls Puberty is a sequence of events in which physical changes occur, resulting in adult physical characteristics and capacity to reproduce. These physical changes are regulated by changes in the... read more and see Puberty in Boys Puberty in Boys Puberty is the stage during which people reach full reproductive ability and develop the adult features of their sex. In boys, puberty usually occurs between the ages of 10 and 14 years. However... read more ). The separation causes the top part of the thighbone to eventually lose its blood supply, decay, and collapse.

Symptoms of SCFE

The first symptom of slipped capital femoral epiphysis may be stiffness or mild pain in the hip. However, the pain may seem to come from the knee or thigh. The pain lessens with rest and worsens with walking or moving the hip. Later, a limp develops, followed by hip pain that extends down the inner thigh to the knee. The affected leg is usually twisted outward.

Diagnosis of SCFE

Treatment of SCFE

  • Surgery

Surgery is usually needed to align the separated ends of the thighbone and to fasten them together with metal screws.

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