Purpose: This study was conducted to assess the posterior inclination of the contralateral femoral epiphysis in patients with unilateral slipped capital femoral epiphysis (SCFE). Methods: The posterior sloping angle (PSA) was measured using lateral radiographs in 67 patients with a unilateral SCFE and in 41 age-matched normal controls. A symptomatic epiphyseal slip was defined as the development of SCFE. Results: The contralateral PSA in SCFE patients was more widely distributed and significantly larger compared to controls (15.0°vs. 9.0°, p < 0.0001). Forty-seven hips (70.1 %) had a PSA of greater than 12.8°, which was +2SD of the control hips. Of the 65 hips excluding the two cases with prophylactic pinning, 11 hips (16.9 %) eventually developed a contralateral SCFE during adolescence and their PSA at the initial visit was significantly larger compared to patients without a contralateral SCFE (18.0°vs. 14.3°, p < 0.005) with a cutoff value of 19°. Conclusions: These findings suggested the possibility of bilateral hip involvement in SCFE patients. Hips with greater degrees of PSA (> 19°) are likely to become symptomatic.
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