ICD-10: M93.064

ICD-10 code M93.064 refers to "Acute slipped upper femoral epiphysis, unspecified stability (nontraumatic), bilateral hips." This condition is a specific type of slipped capital femoral epiphysis (SCFE), which is characterized by the displacement of the femoral head due to slippage at the growth plate (physis) of the femur. Below is a detailed clinical description and relevant information regarding this diagnosis.

Clinical Description

Definition

Acute slipped upper femoral epiphysis (SCFE) 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 happen suddenly and is often associated with pain and limited mobility. The term "nontraumatic" indicates that the condition arises without a specific traumatic event, which is common in cases of SCFE, particularly in adolescents.

Stability Classification

The stability of SCFE is classified into two categories: stable and unstable. In the case of M93.064, the stability is unspecified, meaning that the clinician has not determined whether the condition is stable (the patient can walk with or without pain) or unstable (the patient cannot bear weight due to severe pain). This classification is crucial for determining the appropriate management and treatment options.

Bilateral Involvement

The designation of "bilateral hips" indicates that both hips are affected by the condition. Bilateral SCFE is less common than unilateral cases but can complicate the clinical picture, as it may lead to more significant mobility issues and requires careful monitoring and treatment.

Clinical Presentation

Symptoms

Patients with acute slipped upper femoral epiphysis typically present with:
- Sudden onset of hip or groin pain, which may radiate to the knee.
- Limited range of motion in the hip joint, particularly internal rotation.
- Limping or difficulty walking, which may be more pronounced on the affected side.
- Symptoms may be exacerbated by physical activity.

Risk Factors

Several factors may increase the risk of developing SCFE, including:
- Age: Most commonly occurs in adolescents aged 10 to 16 years.
- Obesity: Higher body mass index (BMI) is associated with increased risk.
- Hormonal changes: Conditions affecting growth and development may play a role.

Diagnosis

Imaging Studies

Diagnosis of acute slipped upper femoral epiphysis typically involves:
- X-rays: Standard imaging to visualize the displacement of the femoral head.
- MRI: May be used in certain cases to assess the extent of slippage and to evaluate the stability of the epiphysis.

Differential Diagnosis

It is essential to differentiate SCFE from other conditions that may present similarly, such as:
- Osteomyelitis
- Septic arthritis
- Transient synovitis

Treatment

Management Options

The treatment for acute slipped upper femoral epiphysis depends on the stability of the condition and may include:
- Surgical intervention: This is often necessary for both stable and unstable cases to prevent further slippage and complications. Options include in situ fixation with screws or pinning.
- Non-surgical management: In stable cases, conservative treatment may involve activity modification and close monitoring.

Prognosis

The prognosis for patients with SCFE varies based on the timing of diagnosis and treatment. Early intervention typically leads to better outcomes, while delayed treatment can result in complications such as avascular necrosis of the femoral head or early osteoarthritis.

Conclusion

ICD-10 code M93.064 captures a critical condition affecting adolescents, characterized by acute slippage of the femoral head at the growth plate. Understanding the clinical presentation, diagnostic criteria, and treatment options is essential for healthcare providers to manage this condition effectively and prevent long-term complications. Early recognition and appropriate intervention are key to optimizing patient outcomes.

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.064, 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

Definition and Mechanism

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 classified as nontraumatic, meaning it can occur without a specific injury, although some cases may be precipitated by minor trauma or stress. The bilateral nature of the condition indicates that both hips are affected, which can complicate the clinical picture and management.

Patient Demographics

• Age Group: Typically occurs in adolescents, most commonly between the ages of 10 and 16 years.
• Gender: More prevalent in males than females, with a ratio of approximately 2:1.
• Obesity: Higher incidence in overweight or obese adolescents, likely due to increased mechanical stress on the hip joint.

Signs and Symptoms

Common Symptoms

1. Hip Pain: Patients often present with pain in the hip or groin area, which may be acute or gradually worsening. The pain can be referred to the knee, leading to misdiagnosis.
2. Limited Range of Motion: There may be a noticeable decrease in the range of motion of the hip joint, particularly in internal rotation.
3. Limping: Affected individuals frequently exhibit a limp, which may be due to pain or mechanical instability in the hip joint.
4. Leg Positioning: The affected leg may appear externally rotated and shortened compared to the unaffected leg.

Physical Examination Findings

• Tenderness: Palpation of the hip joint may reveal tenderness over the femoral head.
• Decreased Internal Rotation: During physical examination, a significant limitation in internal rotation of the hip is often noted.
• Gait Abnormalities: Observations may include a Trendelenburg gait due to weakness in the hip abductors.

Diagnostic Imaging

• X-rays: Standard imaging techniques, such as X-rays, are crucial for diagnosis. They typically show the displacement of the femoral head relative to the femoral neck.
• MRI: In some cases, MRI may be utilized to assess the extent of slippage and to evaluate for associated complications, such as avascular necrosis.

Conclusion

Acute slipped upper femoral epiphysis is a serious condition that requires prompt recognition and management to prevent long-term complications, including osteoarthritis and avascular necrosis. The clinical presentation typically includes hip pain, limited range of motion, and gait abnormalities, particularly in adolescents who may be overweight. Early diagnosis through clinical evaluation and imaging is essential for effective treatment, which may involve surgical intervention to stabilize the femoral head and prevent further slippage.

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 M93.064 specifically refers to this condition when it is bilateral and of unspecified stability. Here are some alternative names and related terms associated with this diagnosis:

Alternative Names

1. Slipped Capital Femoral Epiphysis (SCFE): This is a commonly used term that refers to the same condition, emphasizing the slippage of the capital femoral epiphysis.
2. Bilateral Slipped Upper Femoral Epiphysis: This term highlights that the condition affects both hips.
3. Bilateral SCFE: An abbreviation of slipped capital femoral epiphysis, indicating the bilateral nature of the condition.
4. Acute SCFE: This term specifies the acute nature of the condition, distinguishing it from chronic cases.

Related Terms

1. Epiphyseal Slippage: A general term that describes the movement of the epiphysis relative to the femoral neck.
2. Hip Displacement: A broader term that can refer to various conditions affecting the hip joint, including SUFE.
3. Growth Plate Injury: While not specific to SUFE, this term encompasses injuries that affect the growth plate, which is relevant in the context of epiphyseal slippage.
4. Nontraumatic Hip Disorder: This term can be used to describe conditions like SUFE that occur without a direct traumatic event.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals involved in diagnosis, treatment, and coding for conditions like M93.064. Accurate terminology ensures effective communication among medical teams and aids in the proper documentation and billing processes.

In summary, the condition described by ICD-10 code M93.064 can be referred to by various names, primarily focusing on the nature of the slippage and its bilateral occurrence. Recognizing these terms can enhance clarity in clinical discussions and documentation.

The ICD-10 code M93.064 refers to "Acute slipped upper femoral epiphysis, unspecified stability (nontraumatic), bilateral hips." This condition is characterized by a displacement of the femoral head due to slippage at the growth plate (physis) of the femur, which can occur without a traumatic event. Here’s a detailed overview of the criteria used for diagnosing this condition:

Clinical Presentation

Symptoms

• Hip Pain: Patients often present with hip pain that may be referred to the knee or thigh.
• Limited Range of Motion: There may be a noticeable decrease in the range of motion in the affected hips, particularly in internal rotation.
• Limping: Affected individuals may exhibit a limp or altered gait due to discomfort or instability.

Age Group

• Typically occurs in adolescents, particularly those between the ages of 10 and 16 years, during periods of rapid growth.

Diagnostic Criteria

Medical History

• Nontraumatic Onset: The diagnosis is made when there is no clear history of trauma leading to the condition, distinguishing it from traumatic slipped capital femoral epiphysis (SCFE).
• Growth Patterns: A history of rapid growth or obesity may be relevant, as these factors can contribute to the development of the condition.

Physical Examination

• Assessment of Gait: Evaluation of the patient’s gait can reveal limping or altered walking patterns.
• Range of Motion Tests: A thorough examination of hip mobility, particularly assessing internal and external rotation, is crucial. Limited internal rotation is a common finding.

Imaging Studies

• X-rays: The primary diagnostic tool is radiographic imaging. X-rays of the hips are essential to visualize the displacement of the femoral head. Key findings may include:
• Displacement of the femoral head relative to the femoral neck.
• Changes in the appearance of the growth plate.
• 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.

Classification of Stability

• Unspecified Stability: The term "unspecified stability" indicates that the degree of slippage (stable vs. unstable) has not been determined at the time of diagnosis. This classification is important for treatment planning and prognosis.

Conclusion

Diagnosing acute slipped upper femoral epiphysis (ICD-10 code M93.064) involves a combination of clinical evaluation, patient history, and imaging studies. The absence of trauma, along with characteristic symptoms and radiographic findings, supports the diagnosis. Early recognition and management are crucial to prevent complications such as avascular necrosis or further slippage, which can lead to long-term joint issues. If you have further questions or need additional information on treatment options, feel free to ask!

Acute slipped upper femoral epiphysis (SUFE), classified under ICD-10 code M93.064, 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. Here’s a detailed overview of standard treatment approaches for this condition.

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, often due to hormonal changes, obesity, or mechanical stress. It is classified as "unspecified stability" when the degree of slippage is not clearly defined, and it can occur bilaterally, affecting both hips simultaneously[1].

Symptoms

Patients typically present with hip pain, limited range of motion, and a limp. The pain may be referred to the knee, complicating diagnosis[1].

Standard Treatment Approaches

1. Initial Assessment and Diagnosis

• Clinical Evaluation: A thorough physical examination and medical history are essential to assess symptoms and functional limitations.
• Imaging Studies: X-rays are the primary diagnostic tool, revealing the degree of slippage. MRI may be used for further evaluation if necessary[1].

2. Non-Surgical Management

In cases where the slip is minimal and the patient is stable, non-surgical management may be considered:
- Activity Modification: Patients are advised to limit weight-bearing activities to prevent further slippage.
- Pain Management: Analgesics or anti-inflammatory medications can help manage pain and discomfort[1].

3. Surgical Intervention

Surgical treatment is often required, especially in cases of significant slippage or instability:
- In Situ Fixation: The most common surgical approach involves the insertion of screws to stabilize the femoral head in its proper position. This procedure is typically performed arthroscopically or through an open surgical approach, depending on the case's complexity[1].
- Timing of Surgery: Prompt surgical intervention is crucial to prevent complications such as avascular necrosis of the femoral head or chondrolysis. Ideally, surgery should be performed within days of diagnosis[1].

4. Postoperative Care

• Rehabilitation: After surgery, a structured rehabilitation program is essential to restore hip function and strength. This may include physical therapy focusing on range of motion and strengthening exercises.
• Follow-Up: Regular follow-up appointments are necessary to monitor healing and ensure proper alignment of the femoral head[1].

5. Long-Term Considerations

• Monitoring for Complications: Patients should be monitored for potential complications, including osteoarthritis or further slippage, which may require additional interventions later in life[1].
• Lifestyle Modifications: Encouraging a healthy lifestyle, including weight management and physical activity, can help reduce the risk of recurrence and improve overall joint health[1].

Conclusion

Acute slipped upper femoral epiphysis is a serious condition that requires timely diagnosis and intervention. While non-surgical management may be appropriate in select cases, surgical fixation is often necessary to prevent complications and ensure optimal outcomes. Ongoing monitoring and rehabilitation are critical components of the treatment plan, helping patients regain function and maintain hip health in the long term. If you suspect this condition, it is essential to consult a healthcare professional for a comprehensive evaluation and tailored treatment plan.