ICD-10: M93.012

Acute slipped upper femoral epiphysis (SUFE) is a condition that primarily affects adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate. The ICD-10 code M93.012 specifically refers to this condition when it is stable and occurs in the left hip. Here are some alternative names and related terms associated with this diagnosis:

Alternative Names

1. Slipped Capital Femoral Epiphysis (SCFE): This is the most common alternative name for the condition, emphasizing the slippage of the capital femoral epiphysis.
2. Stable Slipped Capital Femoral Epiphysis: This term highlights the stability of the condition, indicating that the femoral head is not displaced significantly.
3. Acute SCFE: This term is used to specify that the condition has developed suddenly, as opposed to a chronic or gradual onset.

Related Terms

1. Femoral Head Displacement: A general term that describes the movement of the femoral head from its normal position, which is a key feature of SUFE.
2. Growth Plate Injury: This term refers to any injury affecting the growth plate, which is relevant in the context of slipped epiphysis.
3. Hip Slippage: A colloquial term that may be used to describe the condition in layman's terms.
4. Epiphyseal Slippage: This term refers to the slippage of the epiphysis, which is the end part of a long bone, and is relevant in the context of SCFE.

Clinical Context

Understanding these terms is crucial for healthcare professionals when diagnosing and coding for this condition. The distinction between stable and unstable SCFE is particularly important, as it influences treatment decisions and management strategies. The stable variant, as indicated by the ICD-10 code M93.012, typically has a better prognosis compared to its unstable counterpart, which may require more urgent intervention.

In summary, the ICD-10 code M93.012 for acute slipped upper femoral epiphysis, stable (nontraumatic), left hip, is associated with several alternative names and related terms that are important for accurate diagnosis and treatment planning.

Acute slipped upper femoral epiphysis (SUFE) is a condition that primarily affects adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate (physis). The ICD-10 code M93.012 specifically refers to a stable, nontraumatic case of this condition affecting the left hip.

Clinical Description

Definition

Acute slipped upper femoral epiphysis is defined as a displacement of the femoral head relative to the femoral neck, occurring at the growth plate. In stable cases, the patient can bear weight, and the displacement is not severe enough to cause significant instability or risk of avascular necrosis.

Epidemiology

This condition is most commonly seen in adolescents, particularly those aged 10 to 16 years, and is more prevalent in males than females. Factors such as obesity, hormonal changes, and genetic predisposition may contribute to its development[1].

Symptoms

Patients with acute SUFE typically present with:
- Hip or groin pain, which may be referred to the knee.
- Limited range of motion in the hip joint.
- A limp or altered gait pattern.
- Symptoms may develop acutely over days to weeks, often following a period of increased physical activity.

Diagnosis

Diagnosis is primarily clinical, supported by imaging studies. X-rays are the standard imaging modality used to confirm the diagnosis, revealing the characteristic slippage of the femoral head. In stable cases, the displacement is usually less than 30%[2].

Treatment

Management of stable acute slipped upper femoral epiphysis typically involves:
- Surgical intervention: The most common treatment is in situ fixation using screws to stabilize the femoral head and prevent further slippage. This is crucial to avoid complications such as avascular necrosis or chondrolysis.
- Non-surgical management: In some cases, particularly if surgery is not immediately feasible, patients may be advised to limit weight-bearing activities until surgical intervention can be performed.

Prognosis

The prognosis for stable cases of acute SUFE is generally favorable, especially with timely surgical intervention. However, long-term follow-up is necessary to monitor for potential complications, including osteoarthritis or further slippage[3].

Conclusion

ICD-10 code M93.012 encapsulates the clinical picture of stable acute slipped upper femoral epiphysis in the left hip, highlighting the importance of early diagnosis and appropriate management to ensure optimal outcomes for affected adolescents. Regular follow-up and monitoring are essential to address any long-term complications that may arise from this condition.

[1] Source: General epidemiological data on slipped capital femoral epiphysis.
[2] Source: Diagnostic imaging standards for acute slipped upper femoral epiphysis.
[3] Source: Treatment outcomes and long-term prognosis for stable slipped upper femoral epiphysis.

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.012, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate. This condition can lead to significant complications if not diagnosed and treated promptly. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this diagnosis.

Clinical Presentation

Age and Demographics

• Typical Age Range: SUFE commonly occurs in children and adolescents aged 10 to 16 years, with a peak incidence around the ages of 12 to 14 years for boys and slightly later for girls[1].
• Gender: Males are more frequently affected than females, with a ratio of approximately 2:1[1].

Risk Factors

• Obesity: Increased body mass index (BMI) is a significant risk factor, as excess weight can place additional stress on the hip joint[1].
• Endocrine Disorders: Conditions such as hypothyroidism or growth hormone abnormalities may predispose individuals to SUFE[1].
• Genetic Factors: A family history of hip disorders can increase the likelihood of developing this condition[1].

Signs and Symptoms

Common Symptoms

• Hip Pain: Patients typically present with pain in the hip or groin, which may be acute or chronic. The pain can sometimes radiate to the knee[1].
• Limited Range of Motion: There is often a noticeable reduction in the range of motion of the affected hip, particularly in internal rotation[1].
• Limping: Affected individuals may exhibit a limp, which can be due to pain or mechanical instability in the hip joint[1].

Physical Examination Findings

• Positioning: The affected leg may be held in an externally rotated position, which is a classic sign of SUFE[1].
• Tenderness: Palpation of the hip may reveal tenderness over the femoral head or groin area[1].
• Muscle Spasms: In some cases, muscle spasms around the hip joint may be observed, contributing to discomfort and limited mobility[1].

Patient Characteristics

Clinical History

• Onset of Symptoms: Symptoms may develop suddenly (acute) or gradually over weeks to months. Acute cases often present with a sudden increase in pain following minimal trauma or activity[1].
• Previous Episodes: Some patients may have a history of previous episodes of hip pain or instability, which can indicate underlying susceptibility to SUFE[1].

Diagnostic Considerations

• Imaging: Diagnosis is typically confirmed through X-rays, which may show displacement of the femoral head. MRI may be used in certain cases to assess the extent of slippage and any associated complications[1].
• Differential Diagnosis: It is essential to differentiate SUFE from other conditions such as transient synovitis, osteomyelitis, or fractures, which may present with similar symptoms[1].

Conclusion

Acute slipped upper femoral epiphysis (ICD-10 code M93.012) is a significant orthopedic condition that requires prompt recognition and management to prevent long-term complications, including avascular necrosis of the femoral head. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for healthcare providers to ensure timely diagnosis and appropriate treatment. If you suspect a case of SUFE, immediate referral to an orthopedic specialist is recommended for further evaluation and management.

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.012, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate. The diagnosis of this condition involves several criteria, which can be categorized into clinical evaluation, imaging studies, and specific diagnostic criteria.

Clinical Evaluation

1. Patient History:
   - The patient typically presents with hip or groin pain, which may be acute or insidious in onset.
   - A history of recent trauma is often absent in cases classified as stable, as the condition is usually nontraumatic.

2. Physical Examination:
   - Limited range of motion in the hip joint, particularly internal rotation.
   - The patient may exhibit a limp or altered gait.
   - Pain may be elicited during hip movement, especially with internal rotation and abduction.

Imaging Studies

1. X-rays:
   - Anteroposterior (AP) and lateral views of the hip are essential for diagnosis.
   - The presence of a characteristic "slip" of the femoral head on the neck can be observed.
   - The Klein line, which is drawn along the superior border of the femoral neck, should ideally intersect the femoral head. In cases of SUFE, the head may lie below this line.

2. MRI or CT Scans (if necessary):
   - These imaging modalities can provide additional information regarding the extent of slippage and any associated bone marrow edema, which may indicate acute changes.

Diagnostic Criteria

1. Stable vs. Unstable Classification:
   - Stable SUFE: The patient can bear weight on the affected limb without significant pain. This classification is crucial for determining the management approach.
   - Unstable SUFE: The patient experiences severe pain and cannot bear weight, often requiring more urgent intervention.

2. Age and Growth Plate Considerations:
   - Typically occurs in adolescents, often during periods of rapid growth.
   - The condition is more common in males than females and may be associated with obesity or endocrine disorders.

3. Exclusion of Other Conditions:
   - Differential diagnosis should rule out other causes of hip pain in adolescents, such as osteomyelitis, septic arthritis, or other forms of hip dysplasia.

Conclusion

The diagnosis of acute slipped upper femoral epiphysis, stable (nontraumatic), left hip (ICD-10 code M93.012) relies on a combination of clinical assessment, imaging studies, and adherence to specific diagnostic criteria. Early recognition and appropriate management are crucial to prevent complications such as avascular necrosis or chronic pain. If you have further questions or need more detailed information on treatment options, feel free to ask!

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.012, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate. This condition can lead to significant complications if not treated promptly and appropriately. Below, we explore the standard treatment approaches for this condition.

Understanding Acute Slipped Upper Femoral Epiphysis

Definition and Symptoms

Acute SUFE occurs when the femoral head slips off the neck of the femur, typically in a posterior and inferior direction. Symptoms often include:
- Hip or groin pain
- Limited range of motion in the hip
- Limping or altered gait
- Pain that may refer to the knee

Diagnosis

Diagnosis is usually confirmed through clinical evaluation and imaging studies, such as X-rays, which reveal the degree of slippage and any associated complications.

Standard Treatment Approaches

1. Initial Management

• Rest and Activity Modification: Patients are advised to limit weight-bearing activities to prevent further slippage and complications. Crutches or a wheelchair may be recommended to minimize stress on the hip joint.
• Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain and inflammation.

2. Surgical Intervention

Surgical treatment is often necessary for stable cases of acute SUFE to prevent further slippage and complications such as avascular necrosis. The primary surgical options include:

• In Situ Fixation: This is the most common procedure for stable SUFE. It involves the insertion of one or more screws through the femoral neck into the femoral head to stabilize the epiphysis. This method allows for continued growth of the femur while preventing further displacement.

• Open Reduction and Internal Fixation (ORIF): In cases where the slip is more severe or if there is concern about the stability of the epiphysis, an open surgical approach may be necessary. This involves realigning the femoral head and securing it with screws.

3. Postoperative Care

• Rehabilitation: After surgery, a structured rehabilitation program is essential. This typically includes physical therapy to restore range of motion, strength, and function.
• Follow-Up Imaging: Regular follow-up with X-rays is crucial to monitor the position of the femoral head and the healing process.

4. Long-Term Management

• Monitoring for Complications: Patients are monitored for potential complications such as avascular necrosis, chondrolysis, or further slippage. Long-term follow-up is important, as some patients may require additional interventions as they grow.

Conclusion

The management of acute slipped upper femoral epiphysis, particularly in stable cases, emphasizes early diagnosis and surgical intervention to prevent complications. In situ fixation is the standard surgical approach, complemented by a comprehensive rehabilitation program. Continuous monitoring and follow-up care are essential to ensure optimal outcomes and address any long-term issues that may arise. If you suspect SUFE or have concerns about hip pain in adolescents, consulting a healthcare professional for evaluation and management is crucial.