The epidemiology of bilateral slipped capital femoral epiphysis. A study of children in Michigan

R. T. Loder, D. D. Aronson, M. L. Greenfield

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Abstract

The records of 224 children who had a slipped capital femoral epiphysis and who had no underlying metabolic or endocrine disorder were studied retrospectively to investigate the epidemiology of bilateral slipped capital femoral epiphysis. Eighty-two (37 per cent) of the 224 children (fifty-one boys and thirty-one girls) had a bilateral slip. Sixty-four of these children were black and eighteen were white. The age at the time of the diagnosis of the first slip was 13 ± 1.7 years (mean and standard deviation), the duration of the symptoms was 5 ± 5.0 months, and the angle of the slip was 26 ± 16 degrees. Obese children were younger at the time of the diagnosis of the first slip (12 ± 1.6 compared with 13 ± 1.6 years for the children who were not obese, p = 0.001). The diagnosis of a slipped capital femoral epiphysis was made simultaneously in both hips in forty-one children and sequentially in forty-one children. Compared with the children in whom both hips were diagnosed simultaneously, the children in whom the hips were diagnosed sequentially had had a shorter duration of the symptoms before the diagnosis of the first slip (3 ± 2.4 compared with 7 ± 5.9 months, p = 0.0003), were younger at the time of the diagnosis of the first slip (12 ± 1.9 compared with 13 ± 1.2 years, p = 0.001), and tended to be more obese (p = 0.025). In 88 per cent of the patients who had sequential slips, the second slip was diagnosed within eighteen months after the diagnosis of the first slip. The children who had a unilateral slip and in whom a slip of the contralateral hip developed subsequently were younger at the time of the diagnosis of the first slip than those in whom a contralateral slip did not develop (12 ± 1.9 compared with 13 ± 1.6 years, p = 0.002). We recommend frequent follow-up examinations for the first two years after the diagnosis of a unilateral slip, especially if the patient is a girl who is twelve years old or less or a boy who is fourteen years old or less. In order to prevent a delay in the diagnosis of a second slip, follow-up should continue until there is definite radiographic evidence of physeal closure in both hips.

Original languageEnglish (US)
Pages (from-to)1141-1147
Number of pages7
JournalJournal of Bone and Joint Surgery - Series A
Volume75
Issue number8
DOIs
StatePublished - Jan 1 1993

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ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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