The femur is the long bone of the thigh. Its upper end forms a “ball,” called the femoral head, which fits into a “cup” made up of the pelvic bones. In growing children, the end of the femoral head, known as the epiphysis, attaches to the rest of the femur at the growth plate.
Slipped capital femoral epiphysis (SCFE) is a disorder of adolescents. Damage to the growth plate lets the femoral head slip off the neck of the femur. Symptoms can include pain in the groin, inner thigh, or knee. Patients may also have stiffness, trouble rotating the leg, and a changed walk as they try to keep weight off the affected side. Symptoms usually come on gradually, but they can appear suddenly.
Because SCFE often shows up as knee pain, it is easy to miss. Catching it early can prevent severe hip deformity and greatly reduce the risk of permanent joint disability. Delay can turn a stable slip into an unstable one. An unstable slip carries a high risk of avascular necrosis, the death of bone tissue from lost blood supply. The standard treatment is urgent surgery to stabilize the hip and stop further slipping.
In this case, our client collapsed while running. He could not walk and rated his knee pain a 10 out of 10. The emergency department only x-rayed his knee, and the film was normal. Doctors diagnosed him with a knee sprain and discharged him after 30 minutes. He, in fact, did not have a knee sprain, but an acute Grade 3 slip of his left capital femoral epiphysis.
Not every case involves a catastrophic outcome, but a child left in pain with a serious, time-sensitive injury deserves proper care and a fair result. The Townsley Law Firm handled this claim and recovered a settlement of over $40,000.
A Child Who Cannot Walk Needs More Than a Sprain Diagnosis
Our client arrived at the emergency room in a wheelchair. He had collapsed in severe pain and could not walk, a presentation far too serious for a simple sprain. He left with crutches, a knee immobilizer and pain medication, and his discharge instructions told him to see an orthopedic specialist within two to three days.
A young person who collapses in severe pain and cannot bear weight needs a closer look. Inability to walk is a red flag that should prompt a careful evaluation, including consideration of hip conditions, because in children and adolescents, hip problems frequently cause pain that is felt in the knee. A normal knee x-ray in a child who cannot walk does not rule out a hip injury. It points toward one.
Slipped capital femoral epiphysis, or SCFE, is a known and important diagnosis in this age group precisely because it can be missed when the pain is felt in the knee. An evaluation that stops at “knee sprain” without considering the hip, in a child with this presentation, can miss a serious, time-sensitive condition. That is what happened here, and it delayed the treatment he needed.
Five days later, an orthopedic specialist found nothing wrong with the knee. The left hip had no internal rotation, and any movement of the hip caused pain. Our client had not been able to bear weight since he collapsed. A hip x-ray that day showed the Grade 3 slip.
Why SCFE Is Time-Sensitive
Finding the slip did not end the delays. Our client was not sent for emergency care, and instead, the specialist’s office booked him into the wrong clinic at a children’s hospital two days later. When staff caught the error, they sent him to the hospital’s emergency department. A pediatric orthopedic specialist there told the family he never should have been allowed to leave the earlier office because blood flow to his left hip was compromised. Imaging also showed a milder, stable slip in his right hip.
He had surgery the next morning. Surgeons placed two screws in the left hip and one in the right. By then, he had gone more than a week without proper care.
For a growing child, the hip is critical to a lifetime of mobility. Catching SCFE early and treating it appropriately protects against complications that can affect the joint for years. The delays meant this child went longer without the treatment he needed, leaving him with a very high risk of avascular necrosis, enduring unnecessary pain, emotional distress, and added medical costs.
