My teenager has knee pain and a limp. Could it be the hip?

What SUFE is

In a growing teenager, the ball at the top of the thigh bone sits on a growth plate. In SUFE, the ball slips backwards on that growth plate. It happens most often during growth spurts and is more common in teenagers who are overweight or have certain hormonal conditions. It can affect one or both hips.

Signs parents should look for

• A limp, sometimes with the foot turned outwards
• Pain in the knee, thigh or groin, often vague and lasting weeks
• Difficulty running, or tiring quickly in sport
• Reduced ability to turn the leg inwards
• Sudden severe pain and inability to stand after a minor fall: this is an emergency

Because the pain is felt in the knee, SUFE is sometimes missed if only the knee is X-rayed.

Why it is urgent

A slip can get worse, and a severe or unstable slip can damage the blood supply to the ball of the hip. Treatment is usually surgery to fix the ball in place with a screw, done by a children's orthopaedic or hip surgeon. Until then, the child is usually advised to avoid putting weight on the leg and to stop sport. Early diagnosis generally means a smaller slip and a better outlook.

How it is checked in Doha

At Aman Hospital Dr. Gelber examines the hips as well as the knees in every teenager with knee pain and a limp. If SUFE is suspected, X-rays of both hips in two views are taken the same day, and if confirmed your child is referred promptly to a paediatric hip specialist. Other causes, such as Osgood-Schlatter disease or a kneecap problem, are considered too.