Bilateral SCFE: signs, assessment and treatment

SCFE, or slipped capital femoral epiphysis, occurs while the hip growth plate is still open. It needs urgent orthopaedic assessment because continued standing or walking can allow a slip to worsen. Treatment is usually surgical stabilization rather than exercises or watchful waiting.

Each hip can slip to a different degree and symptoms may begin at different times. SCFE commonly presents with a limp and pain in the hip or groin; discomfort may instead be felt in the thigh or knee. The feet may turn outward, and hip rotation can become restricted.

Clinicians examine both hips even when symptoms seem one-sided. X-rays are used to assess the growth plates and guide treatment. The orthopaedic team may also consider whether growth or hormone-related factors need investigation, based on the young person's history and examination.

If SCFE is suspected, stop running, sports and weight bearing, and arrange urgent hospital assessment. Use crutches or assisted transport if available; do not test the hip repeatedly or try to stretch it back into position.

After diagnosis, the surgeon plans stabilization for each affected hip. A screw is commonly placed across the growth plate to prevent further movement. Recovery instructions may differ between sides, so follow the team's specific limits on standing, walking, wound care and return to school or sport.

Go for urgent assessment if a child or adolescent develops a new limp with hip, groin, thigh or unexplained knee pain, particularly when turning the leg is painful or restricted. Sudden severe pain or inability to stand or walk requires emergency assessment.

After surgery, seek prompt advice for increasing wound redness, drainage, fever, worsening pain, new numbness, or a foot that becomes unusually pale or cold. Follow the discharge team's emergency instructions if they are more specific.

Ask how far each hip has slipped, whether both hips require treatment during the same admission, and when weight bearing can restart. Clarify which symptoms after discharge should trigger a return to hospital and what follow-up imaging, physiotherapy or activity progression is planned.