Orthopedic pitfalls in the ED: slipped capital femoral epiphysis

Slipped capital femoral epiphysis (SCFE), though a relatively common disorder, is frequently missed on initial presentation. Symptoms can be vague, the physical examination unrevealing, and radiographic abnormalities subtle. Prompt diagnosis of SCFE is important, however, to improve clinical outcome. The emergency physician needs to remain vigilant for this diagnosis to avoid this orthopedic pitfall. This article examines the clinical presentation, diagnostic techniques, and management options applicable to the emergency physician in the treatment of SCFE.