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The epidemiology of slipped capital femoral epiphysis: an update
Charles L Lehmann1, Raymond R Arons, Randall T Loder
1Department of Orthopaedic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA. cll2107@columbia.edu
Insights
Slipped capital femoral epiphysis (SCFE) is more common in Black and Hispanic children, boys, and those in northern latitudes. Incidence rates appear to be decreasing and occurring at younger ages.
Area of Science:
- Pediatric Orthopedics
- Epidemiology
- Public Health
Background:
- Idiopathic slipped capital femoral epiphysis (SCFE) is a hip condition affecting children and adolescents.
- Previous epidemiological data on SCFE in the United States requires updated analysis.
Purpose of the Study:
- To determine the epidemiology of idiopathic slipped capital femoral epiphysis (SCFE) in children aged 9-16 years in the United States.
- To investigate racial, gender, geographic, and seasonal variations in SCFE incidence.
- To assess trends in age of onset for SCFE.
Main Methods:
- Utilized the Kids' Inpatient Database (1997 and 2000) and US Census Bureau data.
- Analyzed data for pediatric discharges of children aged 9-16 years diagnosed with idiopathic SCFE.
- Calculated incidence rates and relative incidences based on race, gender, and geographic location.
Main Results:
- Overall SCFE incidence was 10.80 cases/100,000 children.
- Relative incidence was 3.94 times higher in Black children and 2.53 times higher in Hispanic children compared to White children.
- Incidence was higher in boys (13.35/100,000) than girls (8.07/100,000).
- Higher rates observed in the Northeast and West, with seasonal variations correlating with latitude.
- Age of onset was lower than previously reported and trending downward.
Conclusions:
- SCFE incidence is higher in Black and Hispanic children and boys than previously reported.
- Geographic and seasonal variations suggest environmental factors, alongside genetics, influence SCFE development.
- The decreasing age of onset warrants further investigation.
Abstract:
The Kids' Inpatient Database, reflecting 6.70 million pediatric discharges in 1997 and 7.30 million in 2000, was coupled with the US Census Bureau data and was used to elicit the epidemiology of idiopathic slipped capital femoral epiphysis (SCFE) that occurred in children 9-16 years. It was found that the overall incidence of SCFE in the United States for these years was 10.80 cases/100,000 children. The relative incidence of SCFE was 3.94 times higher in black children and 2.53 times higher in Hispanic children than in white children. The incidence rate was significantly higher in boys (13.35 cases/100,000 children) than in girls (8.07 cases/100,000 children). Higher incidence rates of SCFE were found in the Northeast and West when compared with rates in the Midwest and the South, suggesting that climate plays a role in the onset of SCFE. Increased incidence of SCFE was noted north of 40 degrees latitude during the summer and south of 40 degrees latitude during the winter. Age of onset was also lower than previously reported and seems to be on a downward trend. This study suggests that the relative incidences of SCFE in blacks and Hispanics are higher than previously reported in the United States. Geographic, racial, and seasonal variations suggest that both environmental and genetic factors may influence the development of SCFE.
