J Korean Orthop Assoc.  2019 Dec;54(6):567-573. 10.4055/jkoa.2019.54.6.567.

Slipped Capital Femoral Epiphysis Associated with Hypopituitarism in Patients over 20 Years

• Na SM
• Kim YU
• Cho YJ
• Jung ST

• KMID: 2469889
• DOI: http://doi.org/10.4055/jkoa.2019.54.6.567

Abstract

Slipped capital femoral epiphysis (SCFE) is a rare disorder of the proximal femur in adolescents. The pathogenesis of SCFE is unclear, but it is believed to be the result of a mechanical insufficiency of the proximal femur physis. SCFE appears to caused by mechanical, endocrinal, and immunological abnormalities. Few cases have reported the SCFE associated with endocrine disorder in the domestic literature, particularly in patients over 20 years old. This paper reports two cases of SCFE associated with hypopituitarism in adults over 20 years old.

Keyword

slipped capital femoral epiphysis; hypopituitarism; adult

MeSH Terms

Adolescent
Adult
Femur
Humans
Hypopituitarism*
Slipped Capital Femoral Epiphyses*

Figure

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  Figure 1 Photograph of the patient shows no axillary or pubic hair and small genitalia (informed consent was obtained from patient).

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  Figure 2 (A) Anteroposterior plain radiograph of the left hip shows posteroinferior displacement of the left femoral epiphysis. The displacement is over 50%. (B) Axial view of computed tomography shows the displacement of the femoral epiphysis in detail.

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  Figure 3 Postoperative plain radiograph of the hip shows complete reduction and internal fixation of the displaced left femoral epiphysis with two cannulated screws and prophylactic screws fixation of the contralateral hip.

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  Figure 4 Plain radiograph of both hip shows physeal closure of the right proximal femur and collapse and osteoarthritis of the left femoral head 12 years after surgery.

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  Figure 5 Photographs of the patient shows no axillary and pubic hair (informed consent was obtained from patient).

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  Figure 6 Anteroposterior plain radiograph of the left hip shows posteroinferior displacement of the left femoral epiphysis.

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  Figure 7 Postoperative plain radiograph of the hip shows valgus osteotomy performed in the subtrochanteric area and internal fixation of displaced left femoral epiphysis with angled blade plate and two cannulated screws.

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  Figure 8 Plain radiograph of the hip shows no progressive collapse of the left proximal femur and union of subtrochanteric area performed at 12 months after surgery.

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