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slipped capital femoral epiphysis
The ball of the ball-and-socket hip joint in adolescents is attached to the femur (thigh bone) by a cartilaginous growth plate. This growth plate is situated at an angle of about 45° to the vertical, and is thus subjected to a lot of force during walking, running and jumping. These forces can cause the cartilage to give way, allowing the ball of the hip joint to slip out of alignment. The result is pain in the hip, thigh, or knee, often with a limp. Both hips may be affected in almost one half of cases.
The condition is most common in overweight or obese African-American adolescent males. Hypothyroidism should be considered for children under 10 who develop the condition.
A high index of suspicion is always warranted for this condition in adolescents with unexplained hip, thigh or knee pain, because it is important for the best long term outcome to treat it as early as possible. The treatment is screw fixation of the femoral head, bed rest, and crutches to prevent further slippage.