Edited by Amy Steele, David Evans - 7/1/2021
Descriptors
Unstable vs. stable - is the patient able to weight bear on the affected lower extremity
Exam Pearls
Abnormal gait/limp (externally rotated, antalgic, Trendelenberg)
Decreased hip ROM - obligatory external rotation; loss of IR, abduction and flexion
May present as referred knee pain (often medial), groin pain, or thigh pain
Workup
Radiographs: AP and frog leg lateral if stable-otherwise cross table lateral
Other imaging: Can consider MRI if high suspicion and negative XR
Labs: Consider CBC, CRP, ESR to rule out SA(septic arthritis), TSH
Other: If positive for SCFE, obtain contralateral hip XR
Management
Need for acute intervention: None usually indicated
Weight-bearing and range of motion: Non-weight bearing while awaiting operative intervention
Type of immobilization: NA
Admission or discharge status: Generally admit for surgery to protect WB
Anticoagulation: None needed/age dependent
Antibiotics: Only perioperative antibiotics indicated
Surgical Indications
Absolute: Most SCFEs will require operative intervention