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. Avoid the pitfall of missing this diagnosis since sending the patient home with the wrong diagnosis will likely worsen the slip. These patients should be put at bedrest. Simple traction is reasonable, however, it is best to discuss this with an orthopedic surgeon.