Slipped upper femoral epiphysis (SUFE), also known as slipped capital femoral epiphysis (SCFE), involves the femoral neck displacing anteriorly and externally rotating along the growth plate relative to the femoral head. The femoral head remains in the acetabulum (hip socket), while the rest of the femur shifts along the growth plate.
It typically occurs in children aged 10-15 years. It is more common in boys and is strongly associated with obesity.
Presentation
The typical exam presentation is an adolescent, obese male undergoing a growth spurt. There may be a history of minor trauma that triggers the onset of symptoms.
Presenting symptoms can be vague, including:
- Hip, groin, thigh or knee pain
- Restricted range of hip movement
- Painful limp
During examination, the child may prefer to keep the hip in external rotation. There will be limited hip movement, particularly internal rotation.
Diagnosis
X-ray is the initial investigation for diagnosing SUFE.
Management
Patients with suspected SUFE should be non-weight-bearing until assessed by orthopaedics.
Surgery is required to stabilise the slip using a screw across the growth plate.
Last updated July 2026
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