While plain radiographs confirm the clinical diagnosis of slipped capital femoral epiphysis (SCFE), advanced imaging offers a deeper understanding of the underlying pathoanatomy—specifically, the role of acquired retroversion in causing gait disturbance, knee pain, and femoroacetabular impingement (FAI). In this manuscript, we synthesize past and recent insights into the pathomechanics of SCFE. Greater recognition of femoral rotation could be achieved by changing the misnomer SCFE to proximal femoral acquired retroversion (PFAR). We hypothesize that rebranding the condition may help enhance understanding among patients and trainees and potentially improve measurement and treatment strategies through imaging and novel surgical approaches that focus on correcting femoral version. Key Concepts: • The history of diagnosing and treating SCFE relied heavily on two-dimensional imaging and therefore underestimates the role of axial rotation in this condition and its sequelae. • The term “SCFE” has contributed to ongoing misunderstandings of this diagnosis and may therefore discourage management approaches that focus on correcting retroversion. • Revisiting the name of this condition can help improve understanding of its three-dimensional aspects and effects (such as gait disturbance, knee pain, femoroacetabular impingement) among patients, families, and trainees. • A new name—proximal femoral acquired retroversion (PFAR)—would align with current fracture terminology conventions, as it describes the displacement of the distal fragment relative to the proximal fragment.
Bellaire et al. (Sun,) studied this question.