American Board of Family Medicine (ABFM) Practice Exam

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What can be a symptom of slipped capital femoral epiphysis in adolescents?

  1. Persistent back pain

  2. Limping and knee pain

  3. Severe headaches

  4. Ankle swelling

The correct answer is: Limping and knee pain

Slipped capital femoral epiphysis (SCFE) is a condition that primarily affects adolescents, typically occurring during periods of growth. A key symptom of SCFE is limping and knee pain. As the femoral head slips off the neck of the femur at the growth plate, it can cause referred pain to the knee, leading many adolescents to present with knee symptoms rather than hip symptoms. The limping results from the affected hip joint and can be a compensatory mechanism due to pain or decreased mobility. Knee pain associated with SCFE can be misleading because patients may not always report hip pain, even if the hip is the origin of their discomfort. As such, when evaluating adolescents with knee pain and a limp, especially those in the age range most affected by SCFE, clinicians should consider this condition as a potential diagnosis. This understanding is crucial for appropriate management and to prevent complications, such as avascular necrosis of the femoral head, which can occur if the slip is not addressed timely.