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What makes slipped capital femoral epiphysis mild versus severe? We have a child with pain so bad, he has to use crutches to walk. Yet the doctor says it's a mild case. Can you explain this to me?

Slipped capital femoral epiphysis (SCFE) is a condition that affects the hip most often in teenagers between the ages of 12 and 16. Cases have been reported as early as age nine years old. In this condition, the growth center of the hip (the capital femoral epiphysis) actually slips backwards on the top of the femur (the thighbone). Left untreated, this can lead to serious problems in the hip joint later in life. Severity of slipped capital femoral epiphysis (SCFE) can be rated as mild, moderate, or severe. This grading is determined by looking on X-rays at the angle of the epiphysis compared to the other side (if the other hip is normal and not also affected by SCFE). Another way to classify severity of the condition is by assessing joint stability. Children who can put weight on the hip and walk (sometimes despite pain and/or with or without crutches) are considered to have a stable SCFE. Children with pain so severe that weight bearing and walking are impossible (even with crutches) are considered to have unstable SCFE. It sounds like your child's condition is mild and stable but with symptoms painful enough to require the support of cructhes. Studies have shown that the more severe the slip, the worse the long-term outcomes. The earlier the diagnosis is made, the more effective the treatment. Fortunately, the condition can be treated and the complications avoided or reduced if recognized early.

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