M93.002 Unspecified slipped upper femoral epiphysis (nontraumatic), left hip

Name of the Condition

• Unspecified slipped upper femoral epiphysis (nontraumatic), left hip

Summary

Unspecified slipped upper femoral epiphysis (SUFE) is a condition where the femoral head (ball of the hip joint) shifts from its normal position on the femoral neck due to a fracture through the growth plate. This nontraumatic form occurs without a specific injury and may lead to hip pain, limping, or altered gait. The condition typically affects adolescents during growth spurts and requires prompt evaluation to prevent complications. The left hip is specified in this code.

Causes

The exact cause of nontraumatic SUFE is not fully understood, but it is associated with mechanical stress on the growth plate during rapid growth. Hormonal changes, particularly those affecting growth plate stability, may contribute. In some cases, underlying endocrine disorders or obesity may play a role, though the condition can also occur without identifiable triggers.

Risk Factors

• Age: Most common in adolescents aged 10–16 years, particularly during rapid growth spurts.
• Gender: Males are more frequently affected than females.
• Obesity: Higher body weight increases stress on the hip joint.
• Endocrine disorders: Conditions like hypothyroidism or growth hormone abnormalities may elevate risk.
• Family history: A genetic predisposition may increase susceptibility.

Symptoms

• Hip, thigh, or knee pain (often unilateral, may be referred to the knee).
• Limp or altered gait (e.g., walking with a limp or toe-out stance).
• Reduced range of motion in the affected hip.
• External rotation of the leg when flexed.
• Pain worsened by activity or weight-bearing.

Diagnosis

Diagnosis involves a physical examination to assess joint function, tenderness, and range of motion. Imaging tests such as X-rays, MRI, or CT scans help visualize bone and cartilage changes. Patient history, including onset of symptoms and activity levels, is also considered. The left hip is specifically evaluated in this code.

Treatment Options

Treatment typically involves surgical stabilization to realign the femoral head and prevent further slipping. Non-surgical options, such as activity modification or casting, may be used in mild cases. Pain management and physical therapy are often part of the recovery process. The specific approach depends on the severity of the slip and patient age.

Prognosis and Follow-Up

With early diagnosis and appropriate treatment, most patients recover well and regain normal hip function. Long-term follow-up is important to monitor for potential complications, such as avascular necrosis or arthritis. Regular check-ups and imaging may be recommended to assess hip joint health over time.

Complications

• Avascular necrosis (loss of blood supply to the femoral head).
• Osteoarthritis of the hip joint.
• Chronic pain or stiffness.
• Leg length discrepancy.
• Recurrence of slipping if not properly stabilized.

Lifestyle & Prevention

• Maintain a healthy weight to reduce stress on the hip joint.
• Avoid high-impact activities that strain the hip during growth spurts.
• Ensure adequate nutrition and exercise to support bone health.
• Seek prompt evaluation for persistent hip or knee pain in adolescents.

When to Seek Professional Help

Consult a healthcare provider if experiencing persistent hip, thigh, or knee pain, especially with limping or reduced mobility. Early intervention is critical to prevent complications and improve outcomes.

Tips for Medical Coders

Use this code for unspecified nontraumatic slipped upper femoral epiphysis affecting the left hip. Document the side (left) and confirm the condition is nontraumatic. Ensure clinical documentation supports the diagnosis and specifies the hip involved. Follow coding guidelines for osteochondropathies and hip disorders.