Thirteen-year-old Sophie presented with a short history of sudden onset of pain in her left hip exacerbated with weight bearing. Prior to this she had intermittent hip pain radiating to her knee for two weeks. Sophie reports that she had not fallen or injured herself in any way. The nurse observes that Sophie is overweight for her age. On arrival in the emergency department Sophie had reduced hip movement and lay on the emergency trolley with her hip externally rotated and flexed. Anteroposterior and frog lateral X-ray views confirmed a slipped capital femoral epiphysis. Sophie was admitted to the ward for initial management of bed rest with simple straight leg traction applied to rest the hip. It was imperative that she did not put weight through the affected leg as this could potentially worsen the slip, requiring more interventional surgery.

The following day Sophie went to theatre for screw fixation of her slipped capital femoral epiphysis. Post-operatively Sophie was mobilised non-weight bearing with crutches for 6 weeks and gradually progressed to full weight bearing by three months after X-rays confirmed physeal healing.

• What are the risk factors associated with SCFE?
• Why were two radiological views required to confirm the diagnosis?
• If the hip is the problem, why does she complain of knee pain?