Background Slipped upper femoral epiphysis (SUFE) is a childhood condition requiring urgent
admission for surgery. It is often complicated by delayed diagnosis.
Discussion A child presenting with hip, thigh or knee pain and reduced hip range of movement
(particularly internal rotation) on the affected side, should arouse clinical suspicion
of SUFE. This should prompt radiographic imaging of the hip with antero-posterior
and lateral hip views. This study shows that most children presenting to The Royal
Children’s Hospital (Melbourne, Victoria) with SUFE from 2003–2007 presented first to
their GP and some faced significant delays to diagnosis and admission. These delays
are of concern as delays have been shown to result in increased severity of physeal
slip and poorer long term outcomes. General practitioners play a crucial role in the
early recognition and diagnosis of SUFE to ensure timely and appropriate referral and
the best possible outcome for the child.
Results The delay from initial presentation to a health professional to hospital admission
ranged from 0–731 days. Most patients (76%) presented initially to their general
practitioner. Of children with stable SUFE, the diagnosis was missed at the initial
consultation in 62 (60%) of 103 children, and there was a delay after X-ray to
diagnosis of 0–11 days. There were no delays from hip radiograph to confirmation in
patients with unstable SUFE.
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