Learning Radiology xray montage

Slipped Capital Femoral Epiphysis

  • Rare less than nine years of age  

  • Boys more than girls  

  • Plain of cartilage changes during adolescence to more a more oblique one predisposing to easier slipping  

  • Higher incidence of slip from June through September

  • Usually boys

    • Blacks more often

    • Ages 10 through 15

    • Usually heavier and or taller than others for their age  

  • Younger in girls 8 to 15 years of age  

  • About 20 to 25 percent are bilateral, an occurrence more frequent in girls.  

  • Imaging Findings 

    • Osteoporosis of head and neck on AP view early

    • Indistinct epiphysis-widened

    • Line along lateral edge of superior femoral neck on AP doesn't intersect epiphysis

    • Metaphysis displaced laterally so that it does not overlap posterior lip of acetabulum as normal

    • Late buttressing medial and posterior on neck  

  • Sequelae

  • Degenerative arthritis

  • Varus deformity

  • Avascular necrosis 6 to 15%

See also Table of Hip Diseases in Children


Slipped capital femoral epiphysis on left-Epiphysis (E) has slipped
inferiorly (compare red arrow on abnormal side to white arrow on normal side), to its original location. The epiphyseal plate is widened on the left. There is an accessory ossification center present (blue arrow), not a fracture.