Bengaluru: A teenager from the city suddenly started experiencing occasional knee pain and a mild limp. When he went for a check-up, the diagnosis was far more serious than his parents expected. He was diagnosed with Slipped Capital Femoral Epiphysis (SCFE), a rare condition in which the ball of the hip joint slips out of place.This rare condition, which used to be seen once every two or three years, is being reported more frequently by doctors in the city. Many of them report seeing at least 2-5 cases a year in their practice, which has raised concerns.The condition typically affects children nearing the age of puberty (10-15 years) and occurs when the growth plate at the top of the thigh bone weakens during adolescence, causing the femoral head to slip backwards and downwards. The initial symptoms are limping, pain in the thigh, hip, knee, or groin that worsens with activity, and restricted hip movement. “We should not neglect any child presenting with pain in the hip joint or limb, or facing difficulty in walking. These symptoms may develop suddenly or gradually. Any child presenting with hip pain should be treated with urgency. It could either be SCFE or a hip infection, both of which require attention at the earliest,” said Dr Mallinath G, consultant-orthopaedic & robotic joint replacement surgery, Manipal Hospitals, Old Airport Road.Dr Noel Naleen Kumar, consultant paediatric orthopaedic surgeon, Hosmat Multispecialty Hospital, conducted a complex hip preservation surgery involving surgical dislocation, realignment of the slipped femoral head, and precise internal fixation on the adolescent mentioned above, while carefully preserving the fragile blood supply to the hip. Kumar said while this case had a positive outcome, such cases are not found in isolation any more. “We are seeing an increasing number of adolescents presenting with SCFE. This rise is closely linked to childhood obesity, endocrine disorders, and lifestyle changes. Many children present late, when the condition already has worsened,” he said.Doctors say while the symptoms can be managed initially, surgery is the only long-term treatment option for SCFE. “While rest, activity changes, crutches and short-term casting are used to manage symptoms during the first treatment phase, surgical treatment becomes necessary for all SCFE cases because it enables doctors to stabilise the hip joint, which stops additional bone displacement. The most common procedure is in-situ pinning, where doctors insert screws through the growth plate to maintain the proper position of the femoral head,” said Dr Yogesh K, senior consultant-arthroscopy and sports injury, Aster Whitefield Hospital.If not treated on time, doctors warn, the condition could lead to serious issues, including requiring hip replacement in early adulthood (as early as 30s). “Children might develop serious complications like worsening of the slippage that leads to the shortening of the limb, difficulty in walking, and arthritis of the hip joint in later stages,” said Dr Mallinath.He, however, said SCFE is not preventable, as the disease could affect any child, but cautioned that early diagnosis and treatment is vital.
