ICD-10: M93.042

Acute 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-CM code M93.042 specifically refers to an unstable, nontraumatic case of this condition affecting the left hip.

Clinical Description

Definition

Acute slipped upper femoral epiphysis occurs when the femoral head, which is the ball at the top of the thigh bone, slips off the neck of the femur. This slippage can lead to significant complications if not addressed promptly. The term "unstable" indicates that the displacement is severe enough that the femoral head is not adequately held in place, increasing the risk of avascular necrosis and other complications.

Etiology

The exact cause of acute SUFE is not fully understood, but it is often associated with factors such as:
- Hormonal changes: Fluctuations during puberty can affect the growth plate.
- Obesity: Increased body weight can place additional stress on the hip joint.
- Genetic predisposition: A family history of hip disorders may increase risk.

Symptoms

Patients with acute SUFE typically present with:
- Hip pain: Often localized to the groin or thigh, which may worsen with activity.
- Limited range of motion: Difficulty in moving the hip, particularly with internal rotation.
- Limping: A noticeable limp may develop due to pain and instability.
- Leg positioning: The affected leg may appear externally rotated and shorter than the other leg.

Diagnosis

Diagnosis is primarily made through clinical evaluation and imaging studies:
- Physical examination: Assessment of hip range of motion and pain response.
- X-rays: Anteroposterior and lateral views of the hip are crucial for visualizing the degree of slippage and confirming the diagnosis.

Treatment

Management of acute SUFE focuses on stabilizing the femoral head and preventing further slippage. Treatment options include:
- Surgical intervention: The most common approach is in situ fixation using screws to stabilize the femoral head and prevent further displacement.
- Non-surgical management: In some cases, particularly if surgery is not immediately available, patients may be placed on crutches and advised to avoid weight-bearing activities until surgical intervention can be performed.

Prognosis

The prognosis for patients with acute SUFE largely depends on the timing of diagnosis and treatment. Early intervention can lead to favorable outcomes, while delayed treatment may result in complications such as avascular necrosis, osteoarthritis, or chronic pain.

In summary, ICD-10 code M93.042 denotes an acute, unstable slipped upper femoral epiphysis in the left hip, a condition that requires prompt diagnosis and management to prevent long-term complications. Understanding the clinical presentation, diagnostic methods, and treatment options is essential for healthcare providers managing this condition.

Acute slipped upper femoral epiphysis (SUFE), particularly the unstable type, is a significant condition that primarily affects adolescents. It is characterized by the displacement of the femoral head due to slippage at the growth plate (physis). Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management.

Clinical Presentation

Definition and Mechanism

Acute slipped upper femoral epiphysis (ICD-10 code M93.042) refers to a condition where the femoral head slips off the neck of the femur due to weakness in the growth plate. This condition can occur nontraumatically, often linked to hormonal changes during puberty, obesity, or other underlying health issues. The unstable variant indicates a more severe displacement, which can lead to complications if not addressed promptly[1].

Patient Characteristics

• Age Group: Typically occurs in adolescents aged 10 to 16 years, with a higher prevalence in boys than girls[1].
• Obesity: Many affected individuals are overweight or obese, which may contribute to the increased mechanical stress on the hip joint[1].
• Ethnicity: There is a noted higher incidence in certain ethnic groups, including African American and Pacific Islander populations[1].

Signs and Symptoms

Common Symptoms

1. Hip Pain: Patients often present with sudden onset of hip pain, which may be localized to the groin or thigh. The pain can be severe and may worsen with activity[1].
2. Limited Range of Motion: There is typically a noticeable reduction in the range of motion of the hip joint, particularly in internal rotation and abduction[1].
3. Limping: Affected individuals may exhibit a limp, often favoring the affected leg. This is due to pain and mechanical instability in the hip joint[1].
4. Referred Pain: Pain may also be referred to the knee, which can sometimes lead to misdiagnosis[1].

Physical Examination Findings

• Decreased Internal Rotation: During physical examination, a significant limitation in internal rotation of the hip is often observed[1].
• Positioning: The affected leg may be held in an externally rotated position, which is a compensatory mechanism to relieve pain[1].
• Tenderness: There may be tenderness over the hip joint and the greater trochanter area[1].

Diagnosis and Imaging

Diagnosis is typically confirmed through imaging studies. X-rays are the first-line investigation, revealing the degree of slippage and any associated complications. In some cases, MRI may be utilized to assess the condition of the cartilage and surrounding soft tissues[1].

Conclusion

Acute slipped upper femoral epiphysis, particularly the unstable type, is a critical condition that requires prompt recognition and intervention. The clinical presentation is characterized by acute hip pain, limited range of motion, and specific physical examination findings. Understanding the patient demographics and symptoms is essential for healthcare providers to ensure timely diagnosis and appropriate management, thereby preventing long-term complications such as avascular necrosis or chronic hip pain[1].

For further management, referral to an orthopedic specialist is often necessary to discuss surgical options, which may include pinning the femoral head to stabilize the epiphysis and prevent further slippage[1].

Acute 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 M93.042 specifically refers to an unstable, nontraumatic case of this condition affecting the left hip. Below are alternative names and related terms associated with this diagnosis.

Alternative Names

1. Slipped Capital Femoral Epiphysis (SCFE): This is a more commonly used term that refers to the same condition, emphasizing the slippage of the capital femoral epiphysis.
2. Upper Femoral Epiphysis Displacement: This term describes the displacement aspect of the condition, focusing on the upper part of the femur.
3. Acute SCFE: This term highlights the acute nature of the condition, indicating a sudden onset of symptoms.
4. Unstable SCFE: This term is used to specify the instability of the epiphysis, which can lead to more severe complications if not treated promptly.

Related Terms

1. Hip Slippage: A general term that may be used to describe the condition in layman's terms.
2. Femoral Head Displacement: This term refers to the displacement of the femoral head, which is a critical aspect of the condition.
3. Growth Plate Injury: While not specific to SUFE, this term relates to the underlying mechanism of the condition, as it involves the growth plate.
4. Adolescent Hip Disorder: This broader term encompasses various hip-related conditions in adolescents, including SUFE.
5. Nontraumatic Hip Slippage: This term specifies that the condition is not due to a traumatic event, which is relevant for M93.042.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M93.042 can enhance communication among healthcare professionals and improve patient education. These terms help clarify the nature of the condition, its implications, and the urgency of treatment. If you need further information on treatment options or management strategies for this condition, feel free to ask!

Acute slipped upper femoral epiphysis (SUFE), particularly the unstable type, is a condition that primarily affects adolescents and involves the displacement of the femoral head due to slippage at the growth plate. The diagnosis of this condition, specifically for the ICD-10 code M93.042, involves several criteria that healthcare professionals typically consider.

Clinical Presentation

1. Symptoms: Patients often present with hip or groin pain, which may be referred to the knee. The pain can be acute in nature and may be associated with limited range of motion in the hip joint. Patients may also exhibit a limp or altered gait due to discomfort.

2. Age Group: SUFE commonly occurs in adolescents, typically between the ages of 10 and 16 years. The condition is more prevalent in males than females, and it is essential to consider the patient's age when diagnosing.

Physical Examination

1. Range of Motion: A physical examination will often reveal a decreased range of motion in the affected hip, particularly in internal rotation. The hip may also be held in a position of flexion and external rotation.

2. Limping: The presence of a limp is a significant indicator, as patients may avoid weight-bearing on the affected side due to pain.

Imaging Studies

1. X-rays: The primary diagnostic tool for SUFE is radiographic imaging. X-rays of the hip will typically show the displacement of the femoral head. In the case of unstable SUFE, there may be significant slippage, which can be classified as mild, moderate, or severe based on the degree of displacement.

2. MRI or CT Scans: In some cases, MRI or CT scans may be utilized to assess the extent of the slippage and to evaluate any associated complications, such as avascular necrosis of the femoral head.

Classification

1. Stability Assessment: The classification of SUFE into stable and unstable is crucial. Unstable SUFE is characterized by the inability to bear weight on the affected limb and is associated with a higher risk of complications. This classification is often determined based on clinical presentation and imaging findings.

2. Nontraumatic Nature: It is important to note that the diagnosis of M93.042 specifies that the condition is nontraumatic, meaning it is not the result of an acute injury but rather a gradual process often related to hormonal changes, obesity, or other underlying factors.

Conclusion

In summary, the diagnosis of acute slipped upper femoral epiphysis, unstable (nontraumatic), left hip (ICD-10 code M93.042) involves a combination of clinical evaluation, physical examination, and imaging studies. Key indicators include the patient's age, symptomatology, physical findings, and radiographic evidence of slippage. Early diagnosis and intervention are critical to prevent complications such as avascular necrosis and to ensure optimal outcomes for the patient.

Acute slipped upper femoral epiphysis (SUFE), particularly the unstable type, is a serious condition that typically affects adolescents and requires prompt medical intervention. The ICD-10 code M93.042 specifically refers to this condition in the left hip. Below, we will explore the standard treatment approaches for this condition, including diagnosis, management, and potential surgical interventions.

Understanding Acute Slipped Upper Femoral Epiphysis

Definition and Causes

Acute slipped upper femoral epiphysis occurs when the femoral head slips off the neck of the femur at the growth plate (physis). This condition is often nontraumatic, meaning it can occur without a significant injury, and is more common in overweight adolescents during periods of rapid growth. The unstable variant indicates a more severe displacement, which can lead to complications if not treated promptly[1].

Symptoms

Patients typically present with:
- Hip or groin pain
- Limited range of motion in the hip
- Limping or difficulty walking
- Pain that may refer to the knee[1].

Diagnosis

Clinical Evaluation

Diagnosis begins with a thorough clinical evaluation, including a detailed history and physical examination. The physician will assess the range of motion and look for signs of pain or discomfort in the hip area.

Imaging Studies

Radiographic imaging is crucial for confirming the diagnosis. Standard X-rays of the hip are typically performed, which may show:
- Displacement of the femoral head
- Changes in the alignment of the hip joint
- Any signs of avascular necrosis, which can occur if blood supply to the femoral head is compromised[2].

Treatment Approaches

Initial Management

1. Activity Modification: Patients are advised to limit weight-bearing activities to prevent further displacement and complications. Crutches or a wheelchair may be recommended for mobility.
2. Pain Management: Analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain and inflammation[3].

Surgical Intervention

For unstable slipped capital femoral epiphysis (SCFE), surgical intervention is often necessary to prevent further slippage and complications such as avascular necrosis. The standard surgical treatments include:

1. In Situ Fixation: This is the most common procedure for unstable cases. It involves the insertion of one or more screws into the femoral head to stabilize the epiphysis and prevent further slippage. The goal is to maintain the position of the femoral head while allowing for continued growth of the femur[4].

2. Open Reduction and Internal Fixation (ORIF): In cases where there is significant displacement, an open reduction may be necessary. This involves surgically repositioning the femoral head into its proper place before securing it with screws or plates[5].

3. Consideration of Growth Plate Status: The surgeon will also consider the status of the growth plate and the potential for future growth when planning the surgical approach. In some cases, additional procedures may be necessary if there is concern about the growth potential of the femoral head[6].

Postoperative Care

Post-surgery, patients typically undergo a rehabilitation program that includes:
- Physical therapy to restore range of motion and strength
- Gradual return to weight-bearing activities as tolerated
- Regular follow-up appointments to monitor healing and detect any complications early[7].

Conclusion

Acute slipped upper femoral epiphysis, particularly the unstable type, is a condition that requires immediate attention to prevent long-term complications. The standard treatment approach involves a combination of initial conservative management followed by surgical intervention to stabilize the femoral head. Early diagnosis and appropriate treatment are crucial for optimal outcomes, allowing affected adolescents to return to their normal activities with minimal long-term effects. Regular follow-up and rehabilitation are essential components of the recovery process to ensure proper healing and function of the hip joint.