The 22nd Annual Meeting of Children's Orthopaedics 14 and 15 March 2008 in Berlin

Abstract

Problem Slipped capital femoral epiphysis is one of the most common hip disorders in adolescence. Often enough the diagnosis is not made straight away after first onset of symptoms. This study underlies the patient's career from onset of symptom to final diagnosis. Materials and methods From 2000 to 2007 91 patients were treated for SCFE and included in the study. The patients were classified as follows: stable or unstable slip. The extent of slippage was graded mild ([30°), moderate (30 -50°), severe ([50°). We recorded the time interval from the first onset of symptoms to the first medical examination. It was documented if the first medical contact was with a non-orthopaedic or orthopaedic physician. We also paid attention to the type of symptoms, the patient had initially. Results From 91 patients there were 71 with a stable and 20 with an unstable slip. 55 patients had a mild, 26 patients a moderate and 10 patients a severe degree of slippage. All unstable slips were diagnosed within 0,72 weeks from onset of symptoms. The delay of diagnosis was 4,5 weeks in patients with a mild slip, 6,5 weeks in cases with moderate slips and 16,9 weeks in those with severe slips. The delay after a visit with a non orthopaedic physician was 9,4 weeks at average and 3,7 weeks after initial contact with an orthopaedic surgeon. If patients complained of knee pain initially there was a significant delay in diagnosis which was 10,3 weeks versus 4,9 weeks after hip pain complains. Conclusion There was a significant delay in diagnosing stable SCFE. The severity of slippage correlates well with the time of delay of diagnosis. Initial contact with non-orthopaedic physicians results in a higher likelihood of diagnostic delays. Keywords slipped capital femoral epiphysis (SCFE), knee pain, delay in diagnosis