Slipped capital femoral epiphysis in children without obesity

Have you ever missed a diagnosis of slipped capital (upper) femoral epiphysis (SCFE) in a non-obese child? Lucina always felt that it was obese children at risk of this orthopaedic complication. Obana, KK et al. [J Pediatr 2020 DOI: https://doi.org/10.1016/j.jpeds.2019.11.037] have evaluated rates and characteristics of SCFE in children who are not obese. This study highlights how often it can occur in the non-obese child with a focus to prevent missed diagnoses and subsequent complications. In a multicentre, retrospective review of patients with a diagnosis of SCFE, body mass index (BMI) percentile for age was calculated and categorised for each patient. Over a 9 year period, 275 patients met their inclusion criteria. Average BMI was 91.2 percentile (range: 8.4–99.7). Thirteen percent (34 patients) were considered “normal weight” (BMI 5%–85%), 17% (48 patients) were considered “overweight” (BMI 85%–95%), and 70% (193 patients) were considered “obese” (BMI >95%). Average BMI percentile was higher in male than female patients (93.2±12.7 vs 88.5±21.4, p=0.034). Patients without obesity were older compared with patients with obesity (12.2±1.7 vs 11.7±1.6 years, p=0.015). Patients without obesity were more likely to present with a severe slip as graded by Wilson percent displacement (27.2% vs …