Slipped capital femoral epiphysis

The usual definition of slipped capital femoral epiphysis (SCFE) is a postero-inferior slip of the femoral head relative to the neck in an overweight adolescent. Its prevalence has increased sharply and progresses with body mass index (BMI) as a function of age. The current classification is clinical, describing two features, stable or unstable SCFE, related to the risk of osteonecrosis. Radiological exploration has three phases. First, diagnosis is hampered by the nonspecific initial symptoms and the subtle radiological signs. Well-trained radiologists can establish the diagnosis at the pre-slip stage. Second, morbidity of surgical treatment and the subsequent functional outcome vary inversely with the size and rapidity of the slip. When SCFE is obvious, imaging seeks to determine the slip angle, the neck deformity, and the potential for residual modeling in order to define the most appropriate surgical management. The follow-up phase includes a search for signs of contralateral involvement, post-treatment monitoring and identifying potential complications such as osteonecrosis or chondrolysis. (C) 2014 Elsevier Masson SAS. All rights reserved.