Case report: bilateral slipped capital femoral epiphyses and hormone replacement.
A 24-year-old woman presented with an 11-year history of bilateral hip pain. Radiographs of the hips revealed severe bilateral slipped upper femoral epiphyses; the left side was more severely slipped than the right. While moving the hips under fluoroscopy we observed motion at the physes and reproduced the patient's pain; the motion confirmed the diagnosis of chronic slipped capital femoral epiphysis. Endocrinology tests showed hypothyroidism. After 1 year of thyroxin therapy, the patient's pain subsided and radiographs of the hips showed fusion of the physes. This case emphasizes the importance of screening for an endocrine disorder in patients with slipped capital femoral epiphysis particularly in adults and shows fusion can occur once the underlying endocrine abnormality is treated.
Nourbakhsh
Ali
A
Division of Spine Surgery, Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0165, USA.
Ahmed
Hasan A
HA
McAuliffe
Thomas B
TB
Garges
Kim J
KJ
D000328:Adult; D001846:Bone Development / Q000187:drug effects; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000187:drug effects; D004839:Epiphyses, Slipped / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D010146:Pain / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D013974:Thyroxine / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D013974:Thyroxine