Patterns of Pain in Adolescents with Slipped Capital Femoral Epiphysis.
OBJECTIVE: To prospectively characterize pain locations in slipped capital femoral epiphysis (SCFE) and evaluate pain locations as predictors of a delay in diagnosis.
STUDY DESIGN: This was an institutional review board approved prospective study of 110 children who underwent surgery for SCFE at a tertiary children's hospital between 2009 and 2015. Standardized pain diagrams were completed by 107 children. Pain zones were designated via a composite diagram. Hips without hip pain were categorized as atypical; hips with hip pain were typical.
RESULTS: In total, 122 hips were eligible for pain zone analysis. Seventy hips (57.4%) had hip pain. Atypical pain was present in 52 hips (42.6%), which included groin pain in 17 hips (13.9%), thigh/leg pain in 43 (35.2%), knee pain in 32 (26.2%), and posterolateral pain of the hip and leg in 13 (10.7%). A combination of pain zones was present in 48 hips (39.3%). Forty-nine percent of patients had more than 1 visit until diagnosis. The three most common pain locations for typical hips were hip, hip/thigh, and hip/knee pain (77.2% of typical hips). The 3 most common pain locations for atypical hips were isolated thigh, knee, and groin (65.4% of atypical hips). The least common pain presentations had a longer duration of symptoms (P = .04) and more healthcare visits before diagnosis (P = .04).
CONCLUSIONS: A combination of pain locations is common in SCFE. Less frequent pain presentations may delay diagnosis. Delays in diagnosis continue despite education efforts.
The Journal of pediatrics
Adolescent; Child; Female; Humans; Male; Pain; Pain Measurement; Prospective Studies; Slipped Capital Femoral Epiphyses
SCFE; adolescent hip; orthopaedics; slipped capital femoral epiphysis
Uvodich, M., Schwend, R. M., Stevanovic, O., Wurster, W., Leamon, J., Hermanson, A. Patterns of Pain in Adolescents with Slipped Capital Femoral Epiphysis. The Journal of pediatrics 206, 184-189 (2019).