Knee pain in slipped femoral capital epiphysis causing a delay in diagnosis

Kaplan, Samuel; Klinghoffer, Leonard

doi:10.1016/0002-9610(61)90730-9

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Knee pain, present in 15% to 50% of SCFE, leads to high rates of misdiagnosis, extra radiographs, higher grade SCFE at treatment, 33,34 and errant surgical procedures directed at nonexistent knee disease. 35 A stable slip, Medicaid insurance, and distal thigh or knee pain are the strongest independent predictors of a delay in diagnosis of SCFE. 34 Altered gait patterns in SCFE include components of antalgic, waddling, or Trendelenburg gait, with an externally rotated foot progression angle.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Slipped Capital Femoral Epiphysis

Georgiadis

Zaltz

2014

Pediatric Clinics of North America

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Section: Clinical Evaluationmentioning

confidence: 99%

Slipped Capital Femoral Epiphysis

Georgiadis

Zaltz

2014

Pediatric Clinics of North America

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“…Slipped Capital Femoral Epiphysis (SCFE) is a musculoskeletal condition seen in the pediatric population where the physis (or "growth plate") of the proximal femur between the head and neck becomes unstable, and the femoral head slips posteriorly and inferiorly away from the neck of the femur. Because SCFE progresses until the physis fuses, early diagnosis and treatment is key [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Unfortunately, delayed diagnosis with SCFE patients can occur, often in patients with uncharacteristic pain presentation and public insurance.…”

Section: Introductionmentioning

confidence: 99%

Examining delays in diagnosis for slipped capital femoral epiphysis from a health disparities perspective

2022

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Slipped Capital Femoral Epiphysis (SCFE) is a skeletal pathology affecting adolescents which requires timely surgery to prevent progression. Delays in diagnosis and treatment of SCFE can negatively affect patient prognosis, and few studies have examined how health disparities and barriers to care may influence these delays. In particular, only a handful of studies have included a Hispanic patient sample, despite this ethnic group’s increased risk for the disease and unique barriers to care. A retrospective chart review was conducted for 124 patients surgically treated for idiopathic SCFE from January 2010 to September 2017. Patient data included age, facility and date of diagnosis, sex, BMI, race and ethnicity, Southwick slip angle, and insurance type. Results indicated that patients with private insurance were more likely to present with a mild slip than patients who were insured by Medicaid or uninsured, while patients without insurance were more likely to have severe slips. Patients without insurance also had a significantly higher mean slip than patients with insurance. The relationship between insurance status and slip angle degree was significant independent of race, even though Hispanic individuals were significantly more likely to have Medicaid or be uninsured. All patients without insurance, and a majority of those with Medicaid, were diagnosed in the emergency department. Time to diagnosis and slip angle were positively correlated, which suggests that longer delays led to increase of the slip angle, consistent with previous findings. Time to diagnosis and BMI were also correlated, which may be tied to socioeconomic factors, but the possibility of weight bias should not be dismissed. These results suggest that socioeconomic status and other factors may have contributed to barriers to care which led to delays in diagnosis and thus more severe slips. Future SCFE research should include health disparities variables to better inform treatment and prognosis.

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“…Regarding SCFE symptomatology, limping and pain in the affected groin, lateral or posterior hip, thigh or ipsilateral knee are commonly observed. SCFE is also likely to present as knee pain, which may account for the high rates of misdiagnoses of this condition ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Acute‑on‑chronic slipped femoral epiphysis following posterior spinal fusion due to idiopathic scoliosis: Case report

et al. 2022

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The aim of this case report is to present a rare case of acute slipped femoral capital on a chronic slipped capital femoral epiphysis (SCFE) after spinal fusion due to idiopathic scoliosis. A 14 year old male patient underwent posterior spinal fusion due to idiopathic thoracic scoliosis. Post-operatively, the patient presented with acute pain in the left hip and a reduced range of motion, which revealed acute SCFE. The patient was then referred to the Second Orthopaedic Department of Agia Sofia Children Hospital in Athens, and underwent percutaneous pinning of the left femur, after which he was discharged uneventfully. The follow up was excellent with no impact on the patient's daily life. The case described is extremely rare in the current literature. The significance of the pre-operative planning is underlined by this case, as well as the need for the spinal surgeon to be aware of the possibility of acute pain in the hip in young adolescents, as SCFE is more common amongst this demographic.

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Knee pain in slipped femoral capital epiphysis causing a delay in diagnosis

Cited by 8 publications

References 7 publications

Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis

Examining delays in diagnosis for slipped capital femoral epiphysis from a health disparities perspective

Acute‑on‑chronic slipped femoral epiphysis following posterior spinal fusion due to idiopathic scoliosis: Case report

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