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What is Slipped upper femoral epiphysis (SUFE)
Slipped Upper Femoral Epiphysis (SUFE), also known as Slipped Capital Femoral Epiphysis (SCFE), is a hip joint condition that typically affects growing children and adolescents between the ages of 10 and 15 years. It occurs when the femoral head (the ball-like top of the thigh bone) slips off the femoral neck through the growth plate (also known as the epiphyseal plate), leading to a misalignment of the hip joint. This slippage can cause pain, limited range of motion, and difficulty walking.
The condition is more common during periods of rapid growth, such as puberty, and is often associated with factors like obesity, hormonal changes, and sometimes, trauma. In many cases, SUFE can occur in one or both hips, and early detection is essential to prevent long-term complications such as arthritis or permanent joint damage.
Treatment of SUFE
SUFE is a serious hip condition that requires prompt medical attention to prevent long-term issues, such as arthritis, joint deformity or avascular necrosis (AVN). While it can be concerning, early diagnosis and treatment are essential for ensuring the best possible outcome and helping your child regain normal hip function and mobility.
In most cases, surgical treatment is necessary to stabilise the hip joint and restore its normal alignment. The earlier the intervention, the better the chances of avoiding complications and supporting your child’s recovery.
An illustration and X-ray of a left SUFE. The femoral head has shifted slightly downward off the neck of the bone through the growth plate (arrow)
Symptoms
The symptoms of Slipped Upper Femoral Epiphysis (SUFE) can vary depending on the severity of the condition, but they typically include:
Hip Pain: Pain is most commonly felt in the groin or thigh, but it can also radiate to the knee. The pain may be dull or sharp and can worsen with movement or activity.
Limping: As the hip joint becomes unstable, children with SUFE often develop a noticeable limp. This may be accompanied by difficulty walking or bearing weight on the affected leg.
Limited Range of Motion: The affected hip may become stiff, making it difficult for the child to move their leg freely, especially when turning the leg inward.
Pain with Movement: Symptoms often worsen with physical activity, including walking, running or playing. Any weight-bearing activity can also exacerbate the pain and discomfort.
How to Diagnose Slipped Upper Femoral Epiphysis (SUFE)
Dr Gary is dedicated to providing the highest level of care and takes great pleasure in alleviating your child’s pain and seeing them regain their mobility.
When you meet with Dr Gary, you can feel confident that your child is in the care of an experienced and compassionate paediatric orthopaedic surgeon who understands the emotional challenges families face. Dr Gary takes a patient-centred approach, ensuring that both you and your child feel supported throughout every step of the consultation and treatment process.
During your appointment, Dr Gary will take the time to carefully assess your child’s hip function, looking for any signs of Slipped Upper Femoral Epiphysis. He will assess hip motion, walking patterns, and any other abnormalities while ensuring your child feels comfortable and at ease.
Dr Gary is committed to providing clear, accessible information about the diagnosis, explaining the condition and its treatment options in a way that is easy to understand. His goal is to ensure you feel fully informed and confident in your child’s care.
With a dedication to restoring mobility and alleviating pain, Dr Gary takes great pride in helping children regain their quality of life, knowing that early intervention can make a world of difference.
Quick Facts about SUFE
Cause
Puberty hormones/Biomechanical factors/ Genetics
Signs/ Symptoms
Difficulty bearing weight on the affected leg, Limited range of motion in hip joint
Treatment
Surgery
Treatment Process
Moderate
Recovery
Surgery 3-6 months
Covered under Medicare?
Yes, select patients may be eligible
Read the SUFE fact sheet
For more information read the Royal Children’s Hospital Melbourne Slipped Upper Femoral Epiphysis Fact Sheet.
SUFE FAQ
SUFE symptoms include
- Difficulty bearing weight on the leg
- Limping or knee pain
- Asymmetry of legs
- An abnormal walking pattern
- A ‘pulled muscle’ feeling in the hip, groin or thigh
- Limited range of motion and mobility in the hip joint
Slipped Upper Femoral Epiphysis (SUFE) is relatively common and occurs between 0.2 and 10 per 100,000 population. It is more prevalent in males than females, with the average age of diagnosis being 13.5 years in males and 12 years in females. About half of the adolescents with SUFE are above the 95th percentile for weight.
The exact cause of SUFE is unknown, however, it is believed to be influenced by a combination of factors, including
- Puberty hormones
- Biomechanical factors that put extra stress on the hip joint, such as obesity
- Genetics
In general, all children with a Slipped Upper Femoral Epiphysis (SUFE) will require surgery to stabilise the hip joint. It is important to avoid standing up and placing weight on the affected leg until the SUFE is stabilised.
There is no successful non-operative approach to SUFE. Some children will also need a realignment of the head of the femur relative to the rest of the bone. This may occur in the acute phase or later, after the slippage is stabilised.
Crutches or a wheelchair may be required for a period of time. Physiotherapy may be started to help improve the strength, flexibility and range of motion in the hip joint.
Recovery can vary greatly depending on the individual case. In a simple, minimally displaced SUFE, the patient may be able to return to full activities after 6 weeks. In more severe SUFE requiring more involved surgery, the rehabilitation process can be many months.
Speak to our friendly team
Not all conditions and symptoms are alike. If you have a concern about your child’s wellbeing or would like to direct questions to Gary Nattrass you may contact our friendly team on 03 9322 3360.
We will gladly take your call and assist you with your enquiry.