Week 3 - Slipped Upper Femoral Epiphysis (SUFE)

Question 1

what is SUFE?

Answer 1

where the femoral head epiphysis slips inferiorly in relation to the femoral neck

Question 2

who does SUFE commonly affect?

Answer 2

overweight pre-pubertal adolescent boys

hypothyroidism and renal disease can predispose

Question 3

what causes SUFE?

Answer 3

growth plate (physis) is not strong enough to support body weight and the femoral epiphysis slips due to the strain

Question 4

what may prelude onset of SUFE?

Answer 4

growth spurt
delayed puberty (hypothyroidism)

Question 5

how does SUFE present?

Answer 5

pain - can be in the groin OR ONLY THE KNEE
limp
loss of internal rotation of the hip = predominant clinical sign

Question 6

what are the 3 types of SUFE?

Answer 6

acute
chronic
acute on chronic

Question 7

how can SUFE pain be felt in the knee?

Answer 7

obturator nerve supplies both hip and the knee

Question 8

how is SUFE diagnosed?

Answer 8

X ray - lateral

- changes may be subtle

Question 9

how is SUFE treated?

Answer 9

urgent surgery to pin the femoral head to prevent further slippage
severe acute slippage = gentle manipulation
chronic severe slips = may need osteotomy

Question 10

what is the risk with gentle manipulation of a severe acute slippage?

Answer 10

avascular necrosis