What should you know about an SCFE hip X-ray?

The X-ray may be taken from more than one view so the clinician can see the femoral head, neck and growth plate from useful angles. They look for a change in the relationship between the head and the rest of the femur, as well as signs that the growth plate is widened or irregular. A subtle slip can be difficult to see on one view, so symptoms and the physical examination still matter. Imaging may include both hips because the opposite side can also require assessment.

Tell the imaging team about the limp, pain location, symptom timing and ability to bear weight. Do not encourage walking around for the appointment if that hurts; ask how to move the child safely. If the images support SCFE, the child is usually kept from weight-bearing while an orthopaedic team decides the next step. Treatment may involve fixation to stabilise the affected growth plate. A normal-looking first image does not remove the need for review when symptoms persist.

Arrange prompt assessment for a growing child with a new limp or unexplained hip, thigh or knee pain. Seek emergency care if the child cannot stand or bear weight, pain becomes severe quickly, or the leg suddenly rests in an outward position. While waiting, avoid sports and unnecessary walking. Worsening symptoms deserve reassessment even if an earlier X-ray was reassuring.

Which X-ray views were obtained? Does the image show a stable or unstable slip? Is the other hip normal on imaging? Could further imaging help? May the child bear any weight while waiting for treatment?