SCFE: Which physical finding is classic at presentation?

SCFE: Which physical finding is classic at presentation?

• A. Internal rotation of the leg with a limp
• B. External rotation of the affected leg with a limp
• C. No leg rotation abnormality
• D. External rotation of both legs

Answer: (B)

In slipped capital femoral epiphysis, the hip loses its normal alignment, so the leg on the affected side tends to rest in external rotation and the patient walks with a limp. The slip causes the femoral head to move posteriorly and inferiorly through the growth plate, which tugs the leg into external rotation, often with limited internal rotation and mild shortening. This external rotation of the affected leg with a limp is the classic physical finding. Internal rotation is typically restricted rather than preserved, and the finding is usually unilateral rather than both legs being externally rotated.

In slipped capital femoral epiphysis, the hip loses its normal alignment, so the leg on the affected side tends to rest in external rotation and the patient walks with a limp. The slip causes the femoral head to move posteriorly and inferiorly through the growth plate, which tugs the leg into external rotation, often with limited internal rotation and mild shortening. This external rotation of the affected leg with a limp is the classic physical finding. Internal rotation is typically restricted rather than preserved, and the finding is usually unilateral rather than both legs being externally rotated.