ICD-10: M93.024

Chronic slipped upper femoral epiphysis (SUFE) is a condition characterized by the displacement of the femoral head due to slippage at the growth plate (physis) of the femur. The ICD-10 code M93.024 specifically refers to a stable, nontraumatic presentation of this condition affecting both hips.

Clinical Description

Definition

Chronic slipped upper femoral epiphysis is a condition that typically occurs in adolescents during periods of rapid growth. It involves a gradual displacement of the femoral head, which can lead to hip pain, limited range of motion, and potential complications if left untreated. The term "stable" indicates that the displacement is not acute and the femoral head remains in a relatively fixed position, which differentiates it from unstable cases where the displacement is more severe and can lead to significant complications.

Epidemiology

This condition is more common in boys than girls and typically presents between the ages of 10 and 16. Factors such as obesity, hormonal changes, and genetic predisposition may contribute to its development. Bilateral involvement, as indicated by the M93.024 code, occurs in approximately 20-40% of cases, often leading to a more complex clinical picture.

Symptoms

Patients with chronic SUFE may present with:
- Hip or groin pain: This pain can be referred to the knee and may worsen with activity.
- Limited range of motion: Particularly in internal rotation and abduction of the hip.
- Limping: Affected individuals may exhibit a limp due to pain or mechanical instability.
- Decreased activity levels: As a result of discomfort and mobility issues.

Diagnosis

Diagnosis typically involves a combination of clinical evaluation and imaging studies:
- Physical Examination: Assessment of hip range of motion, gait analysis, and palpation for tenderness.
- Imaging: X-rays are the primary diagnostic tool, revealing the degree of slippage and any associated changes in the femoral head. MRI may be used in certain cases to assess the condition of the cartilage and surrounding structures.

Treatment

Management of chronic slipped upper femoral epiphysis focuses on preventing further slippage and complications:
- Surgical Intervention: The most common treatment is surgical fixation of the femoral head to the neck using screws or pins. This procedure aims to stabilize the epiphysis and prevent further displacement.
- Non-Surgical Management: In some cases, particularly if the condition is mild and stable, conservative management may be considered, including activity modification and physical therapy.

Prognosis

The prognosis for patients with chronic SUFE is generally favorable, especially when diagnosed early and treated appropriately. However, complications such as avascular necrosis of the femoral head, osteoarthritis, and limb length discrepancies can occur, particularly if the condition is not managed effectively.

Conclusion

ICD-10 code M93.024 encapsulates the clinical picture of chronic slipped upper femoral epiphysis, stable, affecting both hips. Understanding the condition's clinical features, diagnostic criteria, and treatment options is crucial for healthcare providers to ensure timely intervention and optimal patient outcomes. Early recognition and appropriate management can significantly reduce the risk of long-term complications associated with this condition.

Chronic slipped upper femoral epiphysis (SUFE) is a condition that primarily affects adolescents and involves the displacement of the femoral head due to slippage at the growth plate. The ICD-10 code M93.024 specifically refers to the stable, nontraumatic form of this condition affecting both hips. Below are alternative names and related terms associated with this diagnosis.

Alternative Names

1. Bilateral Slipped Capital Femoral Epiphysis (SCFE): This term is often used interchangeably with chronic slipped upper femoral epiphysis, particularly in the context of bilateral involvement.

2. Bilateral Stable Slipped Upper Femoral Epiphysis: This name emphasizes the stability of the condition, distinguishing it from unstable cases.

3. Chronic Bilateral SCFE: This term highlights the chronic nature of the condition while using the abbreviation SCFE, which is commonly recognized in medical literature.

4. Bilateral Hip Slippage: A more general term that describes the condition without the technical jargon, making it easier for patients to understand.

5. Chronic Bilateral Femoral Head Displacement: This term describes the anatomical changes occurring in the femoral head due to the condition.

Related Terms

1. Epiphyseal Slippage: A broader term that encompasses any slippage at the growth plate, not limited to the chronic or stable forms.

2. Growth Plate Disorder: This term refers to any condition affecting the growth plate, including slipped capital femoral epiphysis.

3. Hip Dysplasia: While not synonymous, hip dysplasia can sometimes be confused with SUFE due to its impact on hip joint development.

4. Nontraumatic Hip Disorder: This term categorizes conditions like M93.024 that arise without a direct traumatic event.

5. Pediatric Hip Disorders: A general category that includes various conditions affecting the hip in children and adolescents, including SUFE.

6. Chronic Hip Pain in Adolescents: While not a direct synonym, this phrase is often used in clinical settings to describe symptoms associated with conditions like M93.024.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M93.024 is crucial for accurate diagnosis, treatment, and communication among healthcare providers. These terms help in identifying the condition in various contexts, whether in clinical documentation, patient education, or research discussions. If you need further information on treatment options or management strategies for this condition, feel free to ask!

Chronic slipped upper femoral epiphysis (SUFE), particularly when classified as stable and bilateral, is a condition that primarily affects adolescents and is characterized by the displacement of the femoral head due to slippage at the growth plate. The diagnosis of this condition, represented by the ICD-10 code M93.024, involves several criteria and considerations.

Diagnostic Criteria for M93.024

Clinical Presentation

1. Symptoms: Patients typically present with hip or knee pain, which may be chronic and insidious in onset. Pain can be referred to the knee, leading to misdiagnosis.
2. Physical Examination: Affected individuals may exhibit limited internal rotation of the hip, a limp, or an altered gait pattern. The range of motion may be restricted, particularly in internal rotation and abduction.

Imaging Studies

1. X-rays: The primary diagnostic tool is radiographic imaging. X-rays of the hip are essential to visualize the displacement of the femoral head. In stable cases, the slippage is often less severe, and the femoral head may still be partially in contact with the acetabulum.
   - Frog-leg lateral view: This view is particularly useful for assessing the degree of slippage.
   - AP view: Anteroposterior views can help in evaluating the alignment and position of the femoral head.

2. MRI or CT Scans: In some cases, advanced imaging techniques like MRI or CT scans may be utilized to assess the extent of the slippage and to evaluate any associated changes in the surrounding soft tissues or bone marrow edema.

Classification

• Stable vs. Unstable: The classification into stable and unstable is crucial. Stable SUFE means that the patient can bear weight without significant pain, while unstable SUFE may present with acute symptoms and inability to bear weight. For M93.024, the focus is on stable cases.

Exclusion of Other Conditions

• Differential Diagnosis: It is important to rule out other conditions that may mimic the symptoms of SUFE, such as osteomyelitis, septic arthritis, or other hip disorders. A thorough history and physical examination, along with appropriate imaging, are necessary to exclude these conditions.

Age and Growth Considerations

• Age Group: SUFE typically occurs in adolescents, usually between the ages of 10 and 16 years, during periods of rapid growth. The diagnosis of M93.024 is particularly relevant in this age group.

Conclusion

The diagnosis of chronic slipped upper femoral epiphysis, stable, bilateral (ICD-10 code M93.024) relies on a combination of clinical evaluation, imaging studies, and the exclusion of other potential conditions. Accurate diagnosis is essential for appropriate management and to prevent complications such as avascular necrosis or further slippage. If you have further questions or need additional information on treatment options or management strategies, feel free to ask!

Chronic slipped upper femoral epiphysis (SUFE), particularly when classified under ICD-10 code M93.024, refers to a condition where the femoral head slips off the neck of the femur in a stable manner, typically occurring in adolescents. This condition can affect one or both hips and is characterized by a gradual onset of symptoms, often including hip or knee pain, limited range of motion, and a limp. The management of this condition is crucial to prevent further complications, such as avascular necrosis or osteoarthritis.

Standard Treatment Approaches

1. Initial Assessment and Diagnosis

Before treatment can begin, a thorough assessment is essential. This typically includes:
- Clinical Evaluation: A detailed history and physical examination to assess symptoms and functional limitations.
- Imaging Studies: X-rays are the primary imaging modality used to confirm the diagnosis and evaluate the degree of slippage. MRI may be utilized in certain cases to assess the condition of the femoral head and surrounding structures.

2. Non-Surgical Management

In cases where the condition is stable and the patient is asymptomatic or has mild symptoms, non-surgical management may be appropriate:
- Activity Modification: Patients are often advised to limit weight-bearing activities to reduce stress on the hip joint.
- Physical Therapy: A tailored physical therapy program can help improve strength and range of motion while minimizing pain.
- Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and inflammation.

3. Surgical Intervention

Surgical treatment is typically indicated for symptomatic patients or those with significant slippage. 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 to stabilize the femoral head in its proper position. This procedure aims to prevent further slippage and maintain the integrity of the hip joint.
- Osteotomy: In cases where there is significant deformity or if the femoral head is at risk of avascular necrosis, an osteotomy may be performed. This involves cutting and repositioning the bone to improve alignment and stability.

4. Postoperative Care

Post-surgery, patients typically undergo a rehabilitation program that includes:
- Gradual Weight Bearing: Patients are usually advised to gradually increase weight-bearing activities as tolerated, often starting with crutches.
- Physical Therapy: Continued physical therapy is essential to restore strength and mobility in the hip joint.

5. Long-term Follow-up

Regular follow-up appointments are crucial to monitor the healing process and assess for any complications. This may include:
- Repeat Imaging: X-rays or MRIs may be performed to evaluate the position of the femoral head and the integrity of the fixation.
- Monitoring for Complications: Patients should be monitored for potential complications such as avascular necrosis, which can occur if blood supply to the femoral head is compromised.

Conclusion

The management of chronic slipped upper femoral epiphysis, particularly in a stable condition affecting both hips, requires a comprehensive approach that includes careful assessment, potential surgical intervention, and diligent postoperative care. Early diagnosis and appropriate treatment are essential to prevent long-term complications and ensure optimal outcomes for affected individuals. Regular follow-up is vital to monitor recovery and address any emerging issues promptly.

Chronic slipped upper femoral epiphysis (SUFE), particularly in its stable form, is a condition that primarily affects adolescents and is characterized by a displacement of the femoral head due to slippage at the growth plate. This condition is coded as ICD-10 code M93.024, specifically indicating a bilateral and nontraumatic presentation. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this diagnosis.

Clinical Presentation

Definition and Mechanism

Chronic slipped upper femoral epiphysis occurs when the femoral head slips posteriorly and inferiorly relative to the femoral neck. This condition is often gradual in onset and can be bilateral, meaning it affects both hips. The stable variant indicates that the displacement is not acute and the patient can still bear weight without significant pain.

Patient Demographics

• Age Group: Typically occurs in adolescents, usually between the ages of 10 and 16 years.
• Gender: More common in males than females, with a ratio of approximately 2:1.
• Obesity: Higher prevalence in overweight or obese adolescents, which may contribute to the mechanical stress on the hip joint.

Signs and Symptoms

Common Symptoms

• Hip Pain: Patients often report pain in the hip or groin area, which may be referred to the knee. The pain can be chronic and may worsen with activity.
• Limited Range of Motion: There may be a noticeable decrease in internal rotation of the hip, which can be assessed during physical examination.
• Limping: Affected individuals may present with a limp, particularly when walking or running, due to discomfort and instability in the hip joint.
• Stiffness: Patients may experience stiffness in the hip joint, especially after periods of inactivity.

Physical Examination Findings

• Decreased Internal Rotation: During the physical examination, a significant limitation in internal rotation of the hip is often noted.
• Leg Position: The affected leg may appear to be in an externally rotated position.
• Tenderness: There may be tenderness over the hip joint, particularly in the groin area.

Diagnostic Considerations

Imaging Studies

• X-rays: Standard anteroposterior and lateral views of the hip are essential for diagnosis. X-rays may show the characteristic slippage of the femoral head.
• MRI: In some cases, MRI may be utilized to assess the extent of slippage and to evaluate for any associated complications, such as avascular necrosis.

Differential Diagnosis

• Transient Synovitis: This condition can present similarly but is typically acute and self-limiting.
• Osteochondritis Dissecans: Another condition that may cause hip pain in adolescents but has different underlying pathology.

Conclusion

Chronic slipped upper femoral epiphysis, stable (ICD-10 code M93.024), is a significant condition in pediatric orthopedics that requires careful evaluation and management. Understanding the clinical presentation, including the characteristic signs and symptoms, is crucial for timely diagnosis and intervention. Early recognition and treatment are essential to prevent complications such as avascular necrosis or further slippage, which can lead to long-term joint issues. If you suspect this condition in an adolescent patient, a thorough clinical assessment and appropriate imaging studies are recommended to confirm the diagnosis and guide management.