ICD-10: M93.06

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.06, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage at the growth plate (physis). This condition is categorized as nontraumatic, indicating that it occurs without a direct injury or trauma, although the exact etiology remains unclear.

Clinical Description

Definition and Pathophysiology

Acute slipped upper femoral epiphysis occurs when the femoral head, which is the ball at the top of the thigh bone (femur), slips off the neck of the femur at the growth plate. This slippage can lead to varying degrees of displacement and can affect the stability of the joint. The condition is often associated with hormonal changes during puberty, obesity, and may have a genetic predisposition, although these factors are not fully understood[1].

Symptoms

Patients with acute SUFE typically present with:
- Hip or groin pain: This pain may be referred to the knee or thigh.
- Limited range of motion: Particularly in internal rotation of the hip.
- Limping: Due to pain and mechanical instability.
- Leg positioning: The affected leg may appear externally rotated and shorter than the other leg.

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 some cases, MRI may be utilized to assess the extent of the slippage and to evaluate any associated bone marrow edema[2].

Classification of Stability

The stability of the slip is crucial for management:
- Unstable: If the patient is unable to bear weight or if there is significant displacement.
- Stable: If the patient can bear weight and the displacement is minimal.

M93.06 specifically refers to cases where the stability of the slip is unspecified, meaning that the clinical presentation does not clearly categorize it as stable or unstable at the time of diagnosis[3].

Treatment

The management of acute SUFE typically involves surgical intervention, particularly in cases of unstable slips. The primary treatment options include:
- Screw fixation: This is the most common surgical procedure, where one or more screws are inserted to stabilize the femoral head and prevent further slippage.
- Observation: In stable cases, especially if the slip is minimal, careful monitoring may be considered, although surgical intervention is often recommended to prevent complications such as avascular necrosis of the femoral head.

Complications

Potential complications of untreated or improperly managed SUFE include:
- Avascular necrosis: Loss of blood supply to the femoral head, leading to bone death.
- Chondrolysis: Deterioration of the cartilage in the hip joint.
- Early osteoarthritis: Due to joint instability and altered biomechanics.

Conclusion

Acute slipped upper femoral epiphysis (ICD-10 code M93.06) is a significant orthopedic condition in adolescents that requires prompt diagnosis and management to prevent long-term complications. Understanding the clinical presentation, diagnostic criteria, and treatment options is essential for healthcare providers to ensure optimal outcomes for affected patients. Early intervention is critical, particularly in cases where the stability of the slip is uncertain, to mitigate the risk of serious complications associated with this condition[4].

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.06, is a condition primarily affecting adolescents, characterized by the displacement of the femoral head due to slippage of the growth plate (physis). 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 condition.

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 15 years for boys and 10 to 14 years for girls[1].
• Gender: Males are more frequently affected than females, with a ratio of approximately 2:1 to 3:1[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 and growth hormone abnormalities may predispose individuals to SUFE[1].
• Genetic Factors: A family history of SUFE can increase the likelihood of occurrence, suggesting a genetic predisposition[1].

Signs and Symptoms

Common Symptoms

• Hip Pain: Patients typically present with hip pain, which may be acute or gradual in onset. The pain can be localized to the hip or may radiate to the groin, thigh, or knee[1].
• Limited Range of Motion: There is often a noticeable reduction in the range of motion of the hip joint, 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

• Tenderness: Palpation of the hip may reveal tenderness over the femoral head or groin area[1].
• Deformity: In some cases, there may be an observable deformity of the hip, such as external rotation of the affected leg[1].
• Muscle Spasms: Muscle spasms around the hip joint may be present, contributing to discomfort and limited mobility[1].

Patient Characteristics

Clinical History

• Acute Onset: The condition may present acutely, often following a minor trauma or injury, although it can also occur without any identifiable precipitating event (nontraumatic) [1].
• Duration of Symptoms: Patients may report symptoms lasting from days to weeks before seeking medical attention, which can complicate diagnosis and treatment[1].

Diagnostic Considerations

• Imaging: Diagnosis is typically confirmed through imaging studies, such as X-rays, which can reveal the degree of slippage and any associated complications[1]. MRI may be used in certain cases to assess the condition of the cartilage and surrounding structures[1].

Conclusion

Acute slipped upper femoral epiphysis (ICD-10 code M93.06) is a serious condition that requires prompt recognition and management to prevent long-term complications, including avascular necrosis of the femoral head and osteoarthritis. Awareness of the clinical presentation, signs, symptoms, and patient characteristics is crucial for healthcare providers to ensure timely intervention. If you suspect a case of SUFE, it is essential to refer the patient for appropriate imaging and orthopedic evaluation to confirm the diagnosis and initiate treatment.

Acute slipped upper femoral epiphysis (ICD-10 code M93.06) is a specific condition that can be referred to by various alternative names and related terms. Understanding these terms can be beneficial for healthcare professionals, researchers, and students in the medical field. Below are some of the alternative names and related terms associated with this condition.

Alternative Names

1. Acute Slipped Capital Femoral Epiphysis (SCFE): This term is often used interchangeably with acute slipped upper femoral epiphysis, emphasizing the involvement of the capital femoral epiphysis.

2. Slipped Upper Femoral Epiphysis (SUFE): This is a more general term that may refer to both acute and chronic cases of the condition.

3. Slipped Femoral Epiphysis: A broader term that encompasses any displacement of the femoral epiphysis, which can include both acute and chronic presentations.

4. Nontraumatic Slipped Capital Femoral Epiphysis: This term highlights the nontraumatic nature of the condition, distinguishing it from cases that may arise due to trauma.

Related Terms

1. Epiphyseal Displacement: A term that describes the movement of the epiphysis away from its normal position, which is central to the condition.

2. Hip Displacement: A general term that can refer to various conditions affecting the hip joint, including slipped upper femoral epiphysis.

3. Growth Plate Injury: Since the condition involves the growth plate (physis) of the femur, it can be categorized under injuries affecting growth plates.

4. Pediatric Hip Disorders: This term encompasses a range of conditions affecting the hip in children, including slipped upper femoral epiphysis.

5. Non-traumatic Hip Disorders: A category that includes various hip conditions that are not caused by trauma, including M93.06.

Conclusion

Acute slipped upper femoral epiphysis (M93.06) is a significant pediatric orthopedic condition with various alternative names and related terms that reflect its clinical presentation and implications. Understanding these terms can aid in better communication among healthcare providers and enhance the accuracy of diagnosis and treatment planning. If you need further information or specific details about the condition, feel free to ask!

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 diagnosis of this condition, particularly for the ICD-10 code M93.06, involves several criteria and considerations.

Clinical Presentation

1. Symptoms: Patients typically present with hip or groin pain, which may be referred to the knee. The pain can be acute or chronic, and patients may exhibit a limp or reduced range of motion in the hip joint. Symptoms often worsen with activity and may be accompanied by stiffness in the hip[1].

2. Age Group: SUFE commonly occurs in children and adolescents, particularly those aged between 10 and 16 years. The condition is more prevalent in males than females, and it often occurs during periods of rapid growth[1][2].

Physical Examination

1. Range of Motion: A physical examination will often reveal limited internal rotation of the hip. The affected leg may also appear shorter than the other leg due to the displacement of the femoral head[2].

2. Limping: Patients may present with a characteristic limp, which can be assessed during the examination. The limp is often due to pain and mechanical instability in the hip joint[1].

Imaging Studies

1. X-rays: The primary diagnostic tool for SUFE is radiographic imaging. X-rays of the hip are essential to visualize the displacement of the femoral head. The diagnosis is confirmed by identifying the slippage of the femoral head relative to the neck of the femur on anteroposterior and lateral views[2][3].

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[3].

Classification of Stability

1. Stability Assessment: The stability of the slip is a critical factor in management. Acute slipped upper femoral epiphysis can be classified as stable or unstable based on the ability of the patient to bear weight. A stable slip allows the patient to walk with minimal pain, while an unstable slip results in significant pain and inability to bear weight[1][2].

2. Nontraumatic Nature: The ICD-10 code M93.06 specifically refers to nontraumatic cases, indicating that the condition arises without a direct injury or trauma, which is a key consideration in the diagnosis[3].

Conclusion

The diagnosis of acute slipped upper femoral epiphysis (ICD-10 code M93.06) involves a combination of clinical evaluation, physical examination, and imaging studies. Key criteria include the patient's age, symptomatology, physical findings, and radiographic evidence of slippage. Understanding the stability of the condition is crucial for determining the appropriate management and treatment options. If you suspect a case of SUFE, timely referral to an orthopedic specialist is essential for optimal outcomes.

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.06, 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. Here, we will explore the standard treatment approaches for this condition, focusing on both surgical and non-surgical options.

Understanding Acute Slipped Upper Femoral Epiphysis

Pathophysiology

In SUFE, the femoral head slips off the neck of the femur, which can occur due to various factors, including hormonal changes, obesity, and mechanical stress. The condition is often classified based on stability: stable (where the patient can bear weight) and unstable (where the patient cannot bear weight). However, the unspecified stability in M93.06 indicates that the stability status may not be clearly defined at the time of diagnosis.

Symptoms

Common symptoms include hip or knee pain, limited range of motion, and a noticeable limp. Early diagnosis is crucial to prevent further complications, such as avascular necrosis or osteoarthritis.

Standard Treatment Approaches

1. Non-Surgical Management

In cases where the slip is stable and the patient can bear weight, non-surgical management may be considered. This typically includes:

• Activity Modification: Patients are advised to limit weight-bearing activities to reduce stress on the hip joint.
• Physical Therapy: A tailored physical therapy program may help maintain joint mobility and strengthen surrounding muscles.
• Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be prescribed to manage pain and inflammation.

However, non-surgical management is generally not sufficient for unstable slips or significant displacement.

2. Surgical Intervention

Surgical treatment is the primary approach for most cases of acute SUFE, especially when the slip is unstable or significant. The main surgical options include:

• In Situ Fixation: This is the most common procedure, where screws are inserted to stabilize the femoral head in its proper position. This method aims to prevent further slippage and allows for continued growth of the femur.

• Open Reduction and Internal Fixation (ORIF): In cases of severe displacement or instability, an open reduction may be necessary to realign the femoral head before fixation. This approach is more invasive and typically reserved for complex cases.

• Surgical Timing: The timing of surgery is critical. Early intervention is associated with better outcomes, reducing the risk of complications such as avascular necrosis.

3. 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.
• Follow-Up Imaging: Regular follow-up with X-rays is essential to monitor the position of the femoral head and the healing process.

Conclusion

Acute slipped upper femoral epiphysis (ICD-10 code M93.06) requires prompt and effective treatment to prevent long-term complications. While non-surgical management may be appropriate for stable cases, surgical intervention is often necessary for unstable slips. The choice of surgical technique depends on the severity of the slip and the patient's overall condition. Early diagnosis and intervention are key to achieving favorable outcomes and preserving hip function. Regular follow-up and rehabilitation are crucial components of the recovery process.