UMEM Educational Pearls

Category: Pediatrics

Title: Subtle SCFE

Keywords: SCFE, slipped capitofemoral epiphysis (PubMed Search)

Posted: 10/1/2010 by Adam Friedlander, MD
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Slipped capito-femoral epiphysis (SCFE) is a favorite board exam topic, and typically involves a young early or pre-adolescent obese girl with hip pain and the classic "ice cream falling off the cone" appearance on hip radiographs. However, keep these three pearls in mind when thinking about SCFE:

  1. Girls > Boys, but boys may be older at presentation - don't forget 15 year old boys and SCFE.
  2. An early radiographic finding may only be physis widening, so consider comparison films - the ice cream may only be levitating, but not falling off.
  3. 23% of these children present with knee pain - think before diagnosing an obese 15 year old boy with a knee sprain from football. *bonus* Recall that this injury is non weight-bearing.


Marianne Gausche-Hill, MD, FACEP, Challenging Cases in Pediatric Emergency Medicine, ACEP Scientific Assembly, 2010