PDF(Pubmed)
Abstract：
Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting children and adolescents aged between 9 and 16 years, affecting approximately 10 per 100,000 children per year. The diagnosis of SCFE is often delayed, leading to an increased risk of complications. This study aims to provide the latest evidence concerning the causes of diagnostic delay and risk factors for SCFE and to educate general practitioners and paediatricians to help reduce delays in diagnosis and provide earlier therapeutic intervention. A literature search was conducted in the ScienceDirect and PubMed databases according to the PRISMA statement. Suitable studies for this systematic review included 22 articles discussing the aetiology of SCFE, risk factors, and causes of late diagnosis. Causes of delayed diagnosis include underestimation by patients, initial diagnostic approach by a non-orthopaedic professional, inadequate imaging, failure to recognize morphological changes, and variation in symptomatic presentation. The underlying risk factors for SCFE are likely part of a multifactorial process which involves anatomical variations and the metabolism of leptin, growth hormone, insulin, and other metabolic parameters. This review highlights the importance of early recognition and diagnosis of SCFE and proposes an algorithm for physicians to approach children who may have this condition.
摘要：
滑脱的股骨骨phy（SCFE）是影响9至16岁儿童和青少年的最常见的髋关节疾病，每年每100,000名儿童中大约有10名受到影响。SCFE的诊断经常延迟，导致并发症的风险增加。这项研究旨在提供有关SCFE诊断延迟的原因和危险因素的最新证据，并教育全科医生和儿科医生帮助减少诊断延迟并提供早期治疗干预。根据PRISMA声明，在ScienceDirect和PubMed数据库中进行了文献检索。本系统综述的合适研究包括22篇讨论SCFE病因的文章，危险因素，和晚期诊断的原因。延迟诊断的原因包括患者的低估，非骨科专业人员的初步诊断方法，成像不足,无法识别形态变化，和症状表现的变化。SCFE的潜在风险因素可能是多因素过程的一部分，该过程涉及解剖变异和瘦素代谢，生长激素,胰岛素，和其他代谢参数。这篇综述强调了早期识别和诊断SCFE的重要性，并提出了一种医生接近可能患有这种疾病的儿童的算法。
