In the context of lower extremity issues, what is an early sign of Slipped Capital Femoral Epiphysis?

• A. Decreased internal rotation
• B. Increased knee pain
• C. Limited hip extension
• D. Symmetrical leg length

Answer: (A)

Decreased internal rotation is indeed an early sign of Slipped Capital Femoral Epiphysis (SCFE). This condition typically affects adolescents and involves displacement of the femoral head due to slippage of the growth plate. One of the characteristic physical examination findings in SCFE is a reduction in internal rotation of the hip, which occurs because the position of the femoral head shifts relative to the acetabulum. As the condition progresses, this decrease in internal rotation can become increasingly pronounced, and it often presents alongside other clinical symptoms.

In contrast, symptoms like increased knee pain and limited hip extension, while they can be associated with SCFE or similar conditions, are not typically the earliest indicators. Knee pain may also arise from referred pain due to hip pathologies, complicating the clinical picture. Furthermore, symmetrical leg length would not be expected in SCFE, as the condition could lead to changes in limb length or positioning due to the dislocation or slippage of the femoral head.

Recognizing the early sign of decreased internal rotation is crucial for timely diagnosis and management of SCFE, as prompt intervention can prevent complications such as avascular necrosis of the femoral head.