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Patients with slipped capital femoral epiphysis likely to be misdiagnosed
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Recently published results showed a strong association between slipped capital femoral epiphysis with both area-level socioeconomic deprivation and pre-disease obesity, making patients less likely to be promptly diagnosed.
Daniel C Perry, MB ChB(Hons), PhD, FHEA, FRCS ( Tr & Orth), and colleagues identified 596 patients younger than 16 years of age with a diagnosis of slipped capital femoral epiphysis (SCFE) from 650 primary care practices in the United Kingdom between 1990 and 2013. Main outcome measures included annual incidence, missed opportunities for diagnosis and diagnostic delay.
Results showed an overall incidence rate of 4.8 cases per 100,000 0 to 16-year-olds during the 23-year period. Researchers noted SCFE had a strong association with socioeconomic deprivation and pre-disease obesity. According to results 75.4% of patients had multiple primary care contacts with relevant symptomatology, making diagnostic delays common. Specifically, patients had a significantly longer diagnostic delay if they presented with knee pain vs. hip pain or gait abnormalities, researchers noted.
“Frontline physicians need to be especially alert to hip or knee pain amongst overweight and obese children indicating slipped capital femoral epiphysis,” Perry told Healio.com/Orthopedics. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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