title: Slipped capital femoral epiphysis in an adult with panhypopituitarism.
abstract: Slipped capital femoral epiphysis usually occurs in children going through a pubertal growth spurt, possibly because the immature proximal femoral physis is unable to bear the shear stress. It commonly occurs in adolescents between 10 and 16 years. Slipped capital femoral epiphysis in adults is uncommon, with only 10 cases reported in the literature. This article presents a case of a 29-year-old man with craniopharyngioma diagnosed when he was 19. He underwent surgery with subtotal tumor excision and postoperative radiotherapy, but received no further treatment for the panhypopituitarism concomitant with the tumor. He reported sudden onset of left hip pain after riding a bicycle and underwent surgical fixation 5 days later. He also underwent hormone replacement therapy, including prednisolone, thyroxin, desmopressin, and testosterone, and regular clinical follow-up. His hip function recovered with a painless gait. At 18-month follow-up, neither osteonecrosis nor contralateral slipped capital femoral epiphysis was noted. Furthermore, bilateral proximal femoral physes were also closed. For stable slippage as in this case, in situ pinning fixation is a commendable method. A high index of suspicion of endocrinal disorder and proper management are essential for successful treatment of adult slipped capital femoral epiphysis.
authors.affiliation: Department of Orthopedic Surgery, National Taiwan University Hospital, Taiwan.
authors.forename: Ming-Hsiao
authors.initials: MH
authors.lastname: Hu
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Jian
authors.forename: Yon-Te
authors.initials: YT
authors.lastname: Hsueh
authors.forename: Wei-Hsin
authors.initials: WH
authors.lastname: Lin
authors.forename: Rong-Sen
authors.initials: RS
authors.lastname: Yang
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000295:instrumentation* / Q000379:methods*; D004839:Epiphyses, Slipped / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D016896:Treatment Outcome