PERTHES VS SLIPPED

CAPITAL FEMORAL
EPIPHYSIS(SCFE)
PERTHES DISEASE
Definition
• Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the
proximal femoral epiphysis in children.
Epidemiology
Etiology
Classification
Presentation
Investigation
Treatment
• Operative
o Femoral and / or pelvis osteotomy
o valgus and/or shelf osteotomies
o hip arthroscopy
o hip arthrodiastasis
 SLIPPED CAPITAL
FEMORAL EPIPHYSIS
(SCFE)
Definition
• Displacement of the proximal femoral metaphysis in relation to capital
(proximal) femoral epiphysis.
Epidemiology
Etiology
Etiology
• Most cases idiopathic . No obvious etiology can be found.
• Endocrinopathy
- Hypothyroidism; most common abnormality associated with SCFE
- Growth hormonr deficiency
- Hypopitutarism
Renal osteodystrophy
- Usually associated with bilateral SCFE
Classification
Presentation
Investigation
Treatment
• Operative
o percutaneous in situ fixation
o contralateral hip prophylactic fixation
o open epiphyseal reduction and fixation

• Operative management of symptoms after initial in situ fixation

o Osteochondroplasty
o Proximal femoral osteotomy
TAKE HOME POINTS
• Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral
epiphysis in children.
• Diagnosis can be suspected with hip radiographs. MRI may be required for diagnosis of occult
or early disease.
• Treatment is typically observation in children less than 8 years of age, and femoral and/or
pelvic osteotomy in children greater than 8 years of age.
• Slipped Capital Femoral Epiphysis, is a common condition of the proximal femoral
physis that leads to slippage of the metaphysis relative to the epiphysis, and is most
commonly seen in adolescent obese males.
• Diagnosis can be confirmed with radiographs of the hip. 
• Treatment is usually percutaneous pin fixation. Contralateral pinning is indicated for
patients at high risk, such as those with an initial slip at age < 10, obese males, and
those with endocrine disorders.