In obvious cases, the epiphysis is obviously displaced. In other subtle cases, the physis may appear to be thinner than the normal side. This can occur if the slip occurs posteriorly. Early slips can be difficult to demonstrate radiographically. AP views of the hips can only detect inferior and medial slips.
Early slips tend to slip only in the posterior direction.
Posterior slips are best seen on lateral views of the hips, but these are difficult to obtain. CT scanning can be helpful for orthopedic surgeons, but this is not usually needed in the emergency department. Treatment is largely the responsibility of the orthopedic surgeon. However, one of the major goals of treatment is to prevent further slipping. Further slipping cannot be prevented unless the diagnosis of SCFE is made on the initial presentation.