Aetiology

The aetiology is unclear and is thought to be multifactorial. It includes: (1)

• obesity -
  • 63% of the children who are diagnosed with SCFE have a weight in the 90th percentile or higher
• growth surges
• endocrine disorders
  • less common
  • related disorders include - hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism
  • in patients with unusual presentations (e.g. - patients who are younger than eight years, older than 15 years, or underweight), an endocrine disorder should be considered as the cause of SCFE.

Note:

• trauma causes fracture in a different part of the bone, and it has been variously suggested that it may be caused by hormonal (hypothyroidism and treatment with growth hormone have been implicated) or calcification abnormalities.
• obese children with delayed secondary sexual development, or tall thin boys, appear particularly susceptible to this condition. (2)

Reference:

1. Peck DM, Voss LM, Voss TT; Slipped Capital Femoral Epiphysis: Diagnosis and Management. Am Fam Physician. 2017 Jun 15;95(12):779-784.
2. Herngren B, Stenmarker M, Vavruch L, et al. Slipped capital femoral epiphysis: a population-based study. BMC Musculoskelet Disord. 2017 Jul 18;18(1):304.