A good, stable connection at your hip joint is what lets you walk, run, make that
jump shot, and shake it on the dance floor.
But in some teens — particularly those who
are obese — the thighbone and the hipbone are a little less well connected than
they should be because of a condition called slipped
capital femoral epiphysis (SCFE).
Though the name's quite a mouthful, it simply refers to a shift at the upper part
of the thighbone, or femur, that results in a weakened hip joint. Fortunately, when
recognized early, most cases of SCFE can be treated successfully.
What Is Slipped Capital Femoral Epiphysis?
To understand SCFE, it helps to know a little about the hip joint. The hip is a
ball-and-socket joint, which means that the rounded end of one bone (in this case,
the "ball" of the thighbone) fits into the hollow of another bone (the pelvis). Ball-and-socket
joints offer the greatest range of movement of all types of joints, which is why you
can move your legs forward, backward, and all around.

Kids and teens also have a growth plate at the top of the thighbone
(femur), just under the "ball" portion of the joint. This is called the physis, and
it's made out of cartilage, which is weaker than bone. The job of the physis is to
connect the femoral head (the "ball") to the femur while still allowing the bone to
lengthen and grow.
In SCFE, the "ball" (called the epiphysis) slips off of the top part of the femur,
almost the way a scoop of ice cream might slip off a cone. Sometimes this happens
suddenly — after a fall or sports injury, for example. But it can also happen
gradually, with no previous injury.
With a stable SCFE, a person
feels stiffness or pain in the knee or groin area. A stable SCFE usually causes the
person to limp and walk with the foot turned outward. The pain and the limp typically
tend to come and go, worsening with activity and getting better with rest.
An unstable SCFE is usually much more painful, and the person
won't be able to put weight on the affected side. Because of the direction of the
slipped epiphysis, the person's foot and leg will turn outward (just like in a stable
SCFE). An unstable SCFE is very serious because it can
restrict blood flow to the hip joint.
Sometimes SCFE can irritate the nerves that run down the leg so the person thinks
the pain is coming from the knee. This type of pain is called referred pain,
which means pain starts in one part of the body but is felt in another part. In this
case, pain begins in the affected hip joint but is felt in the normal knee joint.
Catching SCFE early makes a big difference in how easily doctors are able to treat
it.
What Causes It?
No one knows for sure what causes SCFE. Doctors do know SCFE mostly happens in
people between the ages of 11 and 16 who are going through a growth spurt. SCFE is
more common in guys, though girls can have it too.
SCFE is also more likely to happen to teens who have specific stuff going on with
their health, such as:
- obesity
(carrying extra weight puts increased pressure on the growth plate)
- endocrine disorders like diabetes,
thyroid disease, or growth hormone problems
- kidney disease
- treatments for disease, like radiation and chemotherapy for cancer
or taking certain medicines, including steroids