Related Experiment Video
Updated: Mar 17, 2026
Author Spotlight: A Novel 3D-Printed Titanium Implant for Minimally Invasive Treatment of Hip Dysplasia in Young Dogs
Published on: April 19, 2024
Continuing Delay in the Diagnosis of Slipped Capital Femoral Epiphysis
Mathew D Schur1, Lindsay M Andras1, Alexander M Broom1
1Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
Insights
Diagnosis time for slipped capital femoral epiphysis (SCFE) has not improved in a decade. Earlier orthopedic evaluation shortens diagnosis time, and patient education may help reduce delays for subsequent SCFE episodes.
Area of Science:
- Pediatric Orthopedics
- Adolescent Health
- Skeletal Dysplasias
Background:
- Slipped capital femoral epiphysis (SCFE) is a hip condition in adolescents.
- Previous studies indicated significant delays in SCFE diagnosis.
Purpose of the Study:
- To assess if the time from symptom onset to SCFE diagnosis has improved over the last decade.
- To compare diagnostic timelines with previous decades' reports.
Main Methods:
- Retrospective review of 481 pediatric patients diagnosed with SCFE.
- Data collected from three major children's hospitals between 2003 and 2012.
- Analysis of time intervals from symptom onset to diagnosis and provider evaluation.
Main Results:
- Average time from symptom onset to SCFE diagnosis was 17 weeks, showing no improvement over the study period.
- Evaluation at orthopedic clinics significantly reduced diagnosis time compared to primary care or emergency departments.
- Second SCFE episodes were diagnosed faster and were less severe than initial episodes.
Conclusions:
- There has been no improvement in the time to diagnose SCFE over the past decade.
- Earlier orthopedic consultation is crucial for timely SCFE diagnosis.
- Patient and provider education may reduce diagnostic delays, especially for recurrent SCFE.
Objective:
To evaluate whether the time from symptom onset to diagnosis of slipped capital femoral epiphysis (SCFE) has improved over a recent decade compared with reports of previous decades.
Study Design:
Retrospective review of 481 patients admitted with a diagnosis of SCFE at three large pediatric hospitals between January 2003 and December 2012.
Results:
The average time from symptom onset to diagnosis of SCFE was 17 weeks (range, 0-to 169). There were no significant differences in time from symptom onset to diagnosis across 2-year intervals of the 10-year study period (P = .94). The time from evaluation by first provider to diagnosis was significantly shorter for patients evaluated at an orthopedic clinic (mean, 0 weeks; range, 0-0 weeks) compared with patients evaluated by a primary care provider (mean, 4 weeks; range, 0-52 weeks; r = 0.24; P = .003) or at an emergency department (mean, 6 weeks, range, 0-104 weeks; r = 0.36; P = .008). Fifty-two patients (10.8%) developed a second SCFE after treatment of the first affected side. The time from the onset of symptoms to diagnosis for the second episode of SCFE was significantly shorter (r = 0.19; P < .001), with mean interval of 11 weeks (range, 0-104 weeks) from symptom onset to diagnosis. There were significantly more cases of mildly severe SCFE, as defined by the Wilson classification scheme, in second episodes of SCFE compared with first episodes of SCFE (OR, 4.44; P = .001).
Conclusion:
Despite reports documenting a lag in time to the diagnosis of SCFE more than a decade ago, there has been no improvement in the speed of diagnosis. Decreases in both the time to diagnosis and the severity of findings for the second episode of SCFE suggest that the education of at-risk children and their families (or providers) may be of benefit in decreasing this delay.
