What should you know about SCFE hip symptoms?

A child may walk with a shortened stride, rotate the foot outward, or avoid putting full weight through one side. Pain can be mild at first and may be confused with a muscle strain. The discomfort may sit in the groin, upper thigh or knee rather than directly over the hip. Stiffness during hip rotation is another useful clue for a clinician. Symptoms can affect one side, while the other hip may have no complaints even though it needs consideration during assessment.

Treat a new limp or unexplained hip, thigh or knee pain in a growing child as a reason to arrange prompt medical review. Keep the child away from sports, jumping and running. Avoid making them walk to see whether the pain improves. If walking is painful, keep weight off the leg with assistance recommended by a clinician. Write down when symptoms began, whether they are worsening, and whether pain appears at rest or during movement; these details help the assessment.

Seek urgent assessment if a child develops a persistent limp, cannot comfortably bear weight, or has increasing hip, groin, thigh or knee pain. Emergency evaluation is appropriate for sudden severe pain, inability to stand, or a leg that turns outward unexpectedly. Fever, marked swelling or feeling acutely unwell may point to another urgent condition and should not be attributed to SCFE without examination. Do not wait for hip pain to become intense.

Could the knee pain be referred from the hip? How will you check hip rotation and stability? Does the other hip need imaging? Should the child use crutches or avoid all weight? Which symptoms mean we should return immediately?