ICD-10: M93.014

Clinical Description of ICD-10 Code M93.014

ICD-10 Code M93.014 refers to a specific diagnosis known as acute slipped upper femoral epiphysis (SUFE), which is characterized as stable and occurring bilaterally in the hips. This condition is particularly relevant in pediatric and adolescent populations, typically affecting children aged 10 to 16 years, and is more common in males than females.

Definition and Pathophysiology

Acute slipped upper femoral epiphysis is a condition where the femoral head (the ball at the top of the thigh bone) slips off the neck of the femur at the growth plate (physis). In the case of stable slips, the patient can still bear weight on the affected limb without significant pain or instability. The term "nontraumatic" indicates that the slip occurs without a direct injury or trauma, which can often be attributed to factors such as hormonal changes, obesity, or genetic predisposition.

Clinical Presentation

Patients with M93.014 may present with:

• Hip or groin pain: This is often the most common symptom, which may be referred to the knee.
• Limited range of motion: Particularly in internal rotation of the hip.
• Limping: Due to discomfort or instability in the hip joint.
• Leg positioning: The affected leg may appear externally rotated.

Diagnosis

Diagnosis typically involves a combination of clinical evaluation and imaging studies:

• Physical Examination: Assessment of hip range of motion and gait analysis.
• Radiographic Imaging: X-rays are the primary diagnostic tool, revealing the degree of slippage and confirming the diagnosis. In bilateral cases, both hips should be evaluated.

Treatment Options

Management of acute slipped upper femoral epiphysis focuses on preventing further slippage and complications such as avascular necrosis of the femoral head. Treatment options include:

• Surgical Intervention: The most common approach is the surgical fixation of the femoral head using screws to stabilize the epiphysis.
• Non-surgical Management: In some stable cases, especially if the slip is minimal, careful monitoring and activity modification may be considered.

Prognosis

The prognosis for patients with M93.014 is generally favorable if treated promptly. However, delayed treatment can lead to complications, including chronic pain, osteoarthritis, and impaired hip function later in life.

Conclusion

ICD-10 code M93.014 encapsulates a significant pediatric orthopedic condition that requires timely diagnosis and intervention. Understanding the clinical features, diagnostic methods, and treatment options is crucial for healthcare providers managing patients with this condition. Early recognition and appropriate management can lead to better outcomes and preserve hip function in affected individuals.

Acute slipped upper femoral epiphysis (SUFE), particularly when classified under ICD-10 code M93.014, refers to a condition where the femoral head slips off the neck of the femur in a stable manner, affecting both hips. This condition is most commonly seen in adolescents and can lead to significant complications if not diagnosed and treated promptly. Here’s a detailed overview of the diagnostic criteria and considerations for this condition.

Diagnostic Criteria for Acute Slipped Upper Femoral Epiphysis

Clinical Presentation

1. Age and Gender: Typically occurs in adolescents, with a higher prevalence in males. The age range is generally between 10 to 16 years, coinciding with periods of rapid growth.
2. Symptoms: Patients often present with:
   - Hip or groin pain, which may be referred to the knee.
   - Limited range of motion in the hip joint.
   - Limping or altered gait patterns.
   - Symptoms may develop acutely or gradually over time.

Physical Examination

1. Range of Motion: A thorough examination should assess the range of motion in the hip joint. Limited internal rotation is a common finding.
2. Leg Position: The affected leg may appear externally rotated and may be held in a position of flexion and abduction.

Imaging Studies

1. X-rays: The primary diagnostic tool is radiographic imaging. X-rays of the pelvis and hips are essential to confirm the diagnosis. Key findings include:
   - Displacement of the femoral head relative to the femoral neck.
   - The "ice cream cone" appearance on lateral views, indicating slippage.
   - Bilateral involvement may be noted, even if symptoms are unilateral.
2. MRI or CT Scans: In some cases, advanced imaging may be utilized to assess the extent of slippage and to evaluate for any associated complications, such as avascular necrosis.

Classification

• Stable vs. Unstable: The classification of the slip as stable (nontraumatic) indicates that the patient can bear weight on the affected limb without significant pain. This is crucial for determining the management approach.

Differential Diagnosis

• It is important to differentiate SUFE from other conditions that may present similarly, such as:
• Perthes disease
• Osteomyelitis
• Fractures or trauma-related injuries

Conclusion

The diagnosis of acute slipped upper femoral epiphysis, stable, bilateral hips (ICD-10 code M93.014) relies on a combination of clinical evaluation, patient history, and imaging studies. Early recognition and appropriate management are vital to prevent complications such as chronic pain and hip joint degeneration. If you suspect this condition, it is essential to refer the patient for further evaluation and treatment by an orthopedic specialist.

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.014, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate. This condition can be particularly concerning when it occurs bilaterally, as it may lead to significant complications if not addressed promptly. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this condition.

Clinical Presentation

Age and Demographics

• Typical Age Range: SUFE commonly occurs in children and adolescents aged between 10 and 16 years, with a peak incidence during periods of rapid growth.
• Gender: It is more prevalent in males than females, with a ratio of approximately 2:1 to 3:1. However, females may experience more severe cases when they do present with the condition[1][2].

Bilateral Involvement

• Bilateral Slippage: In cases of bilateral SUFE, both hips are affected, which can complicate the clinical picture. Patients may present with symptoms that are less pronounced on one side compared to the other, making diagnosis challenging[3].

Signs and Symptoms

Common Symptoms

• Hip Pain: Patients typically report pain in the hip or groin area, which may be referred to the knee. The pain can be acute or chronic and may worsen with activity.
• Limited Range of Motion: There is often a noticeable reduction in the range of motion of the hip joint, particularly in internal rotation and abduction. This limitation can be assessed during a physical examination[4].
• Limping: Affected individuals may exhibit a limp, which can be attributed to pain or mechanical instability in the hip joint.
• Leg Positioning: The affected leg may appear externally rotated and shortened compared to the unaffected leg, particularly in acute cases[5].

Physical Examination Findings

• Tenderness: Palpation of the hip joint may reveal tenderness over the greater trochanter and the anterior hip region.
• Decreased Strength: Muscle strength around the hip may be diminished due to pain and disuse, impacting the patient's ability to bear weight[6].

Patient Characteristics

Risk Factors

• Obesity: There is a notable association between obesity and the development of SUFE, as excess weight can place additional stress on the hip joint.
• Endocrine Disorders: Conditions such as hypothyroidism and growth hormone abnormalities may predispose individuals to SUFE due to altered growth patterns[7].
• Family History: A familial tendency has been observed, suggesting a genetic component to the condition.

Comorbidities

• Patients with SUFE may also present with other musculoskeletal issues, including hip dysplasia or previous hip injuries, which can complicate the clinical picture and management strategies[8].

Conclusion

Acute slipped upper femoral epiphysis, particularly in its stable form and when bilateral, presents a unique set of challenges in clinical diagnosis and management. Recognizing the signs and symptoms early is crucial for preventing long-term complications, such as avascular necrosis or osteoarthritis. A thorough understanding of patient characteristics, including age, gender, and risk factors, can aid healthcare providers in making timely and effective treatment decisions. If you suspect a case of SUFE, prompt referral to an orthopedic specialist is recommended for further evaluation and management.

ICD-10 code M93.014 refers to "Acute slipped upper femoral epiphysis, stable (nontraumatic), bilateral hips." This condition is characterized by the displacement of the femoral head due to slippage at the growth plate, which can occur in children and adolescents. Here are some alternative names and related terms associated with this diagnosis:

Alternative Names

1. Bilateral Slipped Capital Femoral Epiphysis (SCFE): This term emphasizes the bilateral nature of the condition and is commonly used in clinical settings.
2. Bilateral Stable SCFE: This designation highlights that the condition is stable, meaning there is no significant displacement of the femoral head.
3. Bilateral Acute Slipped Femoral Epiphysis: This term focuses on the acute onset of the condition affecting both hips.

Related Terms

1. Slipped Capital Femoral Epiphysis (SCFE): A broader term that encompasses both stable and unstable forms of the condition, which can occur unilaterally or bilaterally.
2. Epiphyseal Displacement: A general term that refers to the displacement of the epiphysis, which can occur in various conditions, including SCFE.
3. Hip Slippage: A layman's term that may be used to describe the condition in non-medical contexts.
4. Growth Plate Injury: This term refers to injuries affecting the growth plate, which is relevant in the context of SCFE as it involves the growth plate of the femur.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and discussing the condition. It aids in ensuring clear communication among medical teams and with patients regarding the nature of the condition and its implications for treatment and management.

In summary, M93.014 is associated with several alternative names and related terms that reflect its clinical significance and the specific characteristics of the condition. These terms are essential for accurate diagnosis, treatment planning, and effective communication in medical practice.

Acute slipped upper femoral epiphysis (SUFE), particularly in its stable form, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate. The ICD-10 code M93.014 specifically refers to this condition when it occurs bilaterally and is nontraumatic. Here’s a detailed overview of the standard treatment approaches for this condition.

Understanding Acute Slipped Upper Femoral Epiphysis

Definition and Symptoms

Acute slipped upper femoral epiphysis occurs when the femoral head slips off the neck of the femur at the growth plate. 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 typically involves a combination of clinical evaluation and imaging studies, such as X-rays, which can reveal the characteristic slippage of the femoral head.

Standard Treatment Approaches

1. Observation and Activity Modification

In cases of stable slipped capital femoral epiphysis (SCFE), particularly when symptoms are mild, initial management may involve:
- Activity modification: Reducing weight-bearing activities to minimize stress on the hip joint.
- Pain management: Using nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate discomfort.

2. Surgical Intervention

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

a. In Situ Fixation

• Procedure: This is the most common surgical approach for stable SCFE. It involves the insertion of one or more screws through the femoral neck into the femoral head to stabilize the epiphysis.
• Indications: Recommended for patients with stable SCFE to prevent further displacement and complications.

b. Open Reduction and Internal Fixation (ORIF)

• Procedure: In cases where there is significant displacement or if the condition is unstable, an open reduction may be performed to realign the femoral head, followed by internal fixation.
• Indications: This approach is more common in unstable cases or when there is a risk of complications.

3. Postoperative Care

Post-surgery, patients typically undergo:
- Rehabilitation: Physical therapy to restore range of motion and strength.
- Follow-up imaging: Regular X-rays to monitor the position of the femoral head and the healing process.

4. Long-term Management

Long-term follow-up is crucial as patients with SCFE are at risk for:
- Avascular necrosis: Due to compromised blood supply to the femoral head.
- Early osteoarthritis: Resulting from joint incongruity or damage.

Conclusion

The management of acute slipped upper femoral epiphysis, particularly in stable cases, primarily revolves around surgical intervention to stabilize the femoral head and prevent complications. Early diagnosis and appropriate treatment are essential to ensure optimal outcomes and minimize the risk of long-term joint issues. Regular follow-up and rehabilitation play critical roles in the recovery process, allowing patients to return to their normal activities safely.