What are the key clinical signs and symptoms to consider when diagnosing Slipped Capital Femoral Epiphysis (SCFE) in adolescents?

When considering the diagnosis of Slipped Capital Femoral Epiphysis (SCFE) in adolescents, key clinical signs and symptoms primarily involve hip discomfort and altered movement NICE CKS. Specifically, adolescents older than 9 years of age presenting with painful or restricted hip movements should raise suspicion for SCFE NICE CKS. A particularly important finding is restricted internal rotation of the hip NICE CKS. While the provided literature indicates that clinical presentation is a key aspect of evaluating SCFE Georgiadis & Zaltz 2014Bittersohl et al. 2019, the specific symptoms detailed in the UK guidelines are crucial for initial assessment NICE CKS. Given the potential for SCFE, especially in a child presenting with a limp, there should be a low threshold for arranging same-day X-rays to investigate concerns about slipped upper femoral epiphysis NICE CKS,NICE CKS,NICE CKS. Early specialist assessment is recommended for children older than 9 years with these painful or restricted hip movements to exclude SCFE NICE CKS.