This is one orthopaedic problem that can be missed without getting diagnosed early, if the symptoms are not read closely — Slipped Capital Femoral Epiphysis (SCFE). Simplified, it is a case of the ball-shaped head of thigh bone (femur) slipping out of the socket where it joins the hip. This occurs in boys and girls aged 11-16, unlike the similarly pain-inducing arthritic hip joint that normally affects the 50-plus age group.
“This happens typically in children if they are a bit bulky and involve in sports and other intense activities such as dance. The femoral head slips from the socket, resulting in pain and drastically curtailed movement,” says orthopaedic surgeon Satheesh Kumar S. Pillai.
Symptoms
Citing the case of a girl who had to miss school for a couple of years because of this problem, Dr. Pillai says pain and swelling in the hip joint are the symptoms of the onset of the problem. Analgesics provide temporary relief. The pain returns as the core problem is not tackled.
As the condition worsens, severe pain and decrease in range of motion of the joint make the patient wheel chair-bound.
In children and those in early teens, the bone continues to grow. A cartilage plate called physis is present in this age group to facilitate growth (referred to as growth plate). High intensity action by a slightly obese body can result in the thigh bone slipping out through the physis, as if through a very soft layer of cheese. The excess weight and intense activity combine put immense stress on the growth plate.
Fixable
A stable SCFE can be quickly fixed if detected early. The intermittent pain that comes with activity and disappears with rest serves as an indicator. But, an unstable SCFE would involve greater and consistent pain. The leg on the affected side becomes hard to use.
Without proper treatment, the condition can lead to the femoral head suffering from lack of blood supply and tissue loss. A microsurgery is done to put a screw through the bone and plate to hold these in place, primarily to stablise the hip joint. This is a life quality enhancement procedure, because pain virtually cuts off movement.
Dr. Pillai points out that reading the signs is important to detect the problem early and reduce the trauma. Valuable school and sporting time can become a casualty for youngsters.
(Reporting by K.V. Prasad)
