Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 3/2008

01-03-2008 | Case Report

Case Report

Bilateral Slipped Capital Femoral Epiphyses and Hormone Replacement

Authors: Ali Nourbakhsh, MD, Hasan A. Ahmed, MCh Orth, FRCS (Tr & Orth), Thomas B. McAuliffe, MA, FRCS, Kim J. Garges, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2008

Login to get access

Abstract

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.
Literature
1.
Abraham E, Garst J, Barmada R. Treatment of moderate to severe slipped capital femoral epiphysis with extracapsular base-of-neck osteotomy. J Pediatr Orthop. 1993;13:294–302.PubMed
2.
Aeschlimann D, Wetterwald A, Fleisch H, Paulsson M. Expression of tissue transglutaminase in skeletal tissues correlates with events of terminal differentiation of chondrocytes. J Cell Biol. 1993;120:1461–1470.PubMedCrossRef
3.
Blethen SL, Rundle AC. Slipped capital femoral epiphysis in children treated with growth hormone: a summary of the National Cooperative Growth Study experience. Horm Res. 1996;46:113–116.PubMedCrossRef
4.
Bosch P, Johnston CE, Karol L. Slipped capital femoral epiphysis in patients with Down syndrome. J Pediatr Orthop. 2004;24:271–277.PubMed
5.
Canale ST. Problems and complications of slipped capital femoral epiphysis. Instr Course Lect. 1989;38:281–290.PubMed
6.
Canale ST. Fractures, dislocations in children. In: Canale ST, ed. Campbell’s Operative Orthopaedics. Vol 2. Part 11. 10th ed. Philadelphia, PA: CV Mosby; 2002:1493–1496.
7.
Carney BT, Weinstein SL, Noble J. Long-term follow-up of slipped capital femoral epiphysis. J Bone Joint Surg Am. 1991;73:667–674.PubMed
8.
Crawford AH, MacEwen GD, Fonte D. Slipped capital femoral epiphysis co-existent with hypothyroidism. Clin Orthop Relat Res. 1977;122:135–140.PubMed
9.
El-Mowafi H, El-Adl G, El-Lakkany MR. Extracapsular base of neck osteotomy versus Southwick osteotomy in treatment of moderate to severe chronic slipped capital femoral epiphysis. J Pediatr Orthop. 2005;25:171–177.PubMedCrossRef
10.
Freitas FR, Capelo LP, O’Shea PJ, Jorgetti V, Moriscot AS, Scanlan TS, Williams GR, Zorn TM, Gouveia CH. The thyroid hormone receptor beta-specific agonist GC-1 selectively affects the bone development of hypothyroid rats. J Bone Miner Res. 2005;20:294–304.PubMedCrossRef
11.
Fron D, Forgues D, Mayrargue E, Halimi P, Herbaux B. Follow-up study of severe slipped capital femoral epiphysis treated with Dunn’s osteotomy. J Pediatr Orthop. 2000;20:320–325.PubMedCrossRef
12.
Glade MJ, Kanwar YS, Stern PH. Insulin and thyroid hormones stimulate matrix metabolism in primary cultures of articular chondrocytes from young rabbits independently and in combination. Connect Tissue Res. 1994;31:37–44.PubMedCrossRef
13.
Heyerman W, Weiner D. Slipped epiphysis associated with hypothyroidism. J Pediatr Orthop. 1984;4:569–573.PubMed
14.
Ishikawa Y, Genge BR, Wuthier RE, Wu LN. Thyroid hormone inhibits growth and stimulates terminal differentiation of epiphyseal growth plate chondrocytes. J Bone Miner Res. 1998;13:1398–1411.PubMedCrossRef
15.
Jingushi S, Hara T, Sugioka Y. Deficiency of a parathyroid hormone fragment containing the midportion and 1,25-dihydroxyvitamin D in serum of patients with slipped capital femoral epiphysis. J Pediatr Orthop. 1997;17:216–219.PubMedCrossRef
16.
Kallio PE, Mah ET, Foster BK, Paterson DC, LeQuesne GW. Slipped capital femoral epiphysis: incidence and clinical assessment of physeal instability. J Bone Joint Surg Br. 1995; 77:752–755.PubMed
17.
Kartenbender K, Cordier W, Katthagen BD. Long-term follow-up study after corrective Imhäuser osteotomy for severe slipped capital femoral epiphysis. J Pediatr Orthop. 2000;20:749–756.PubMed
18.
Loder RT, Greenfield ML. Clinical characteristics of children with atypical and idiopathic slipped capital femoral epiphysis: description of the age-weight test and implications for further diagnostic investigation. J Pediatr Orthop. 2001;21:481–487.PubMedCrossRef
19.
Loder RT, Wittenberg B, DeSilva G. Slipped capital femoral epiphysis associated with endocrine disorders. J Pediatr Orthop. 1995;15:349–356.PubMed
20.
Lubicky JP. Chondrolysis and avascular necrosis: complications of slipped capital femoral epiphysis. J Pediatr Orthop B. 1996;5:162–167PubMed
21.
Macnicol MF, Benson MKD. Slipped capital femoral epiphysis. In: Benson MKD, Fixsen JA, Macnicol MF, Parsch K, eds. Children’s Orthopaedics, Fractures. London, UK: Churchill Livingstone; 2002:397–407.
22.
Mann DC, Weddington J, Richton S. Hormonal studies in patients with slipped capital femoral epiphysis without evidence of endocrinopathy. J Pediatr Orthop. 1988;8:543–545.PubMed
23.
Nurminskaya M, Kaartinen MT. Transglutaminases in mineralized tissues. Front Biosci. 2006;11:1591–1606.PubMedCrossRef
24.
Orofino C, Innis JJ, Lowrey CW. Slipped capital femoral epiphysis in Negroes: a study of ninety-five cases. J Bone Joint Surg Am. 1960;42:1079–1083.
25.
Paley D, Fink B, Herzenberg JE. Pseudarthrosis following slipped capital femoral epiphysis: treatment with reduction with use of gradual distraction: a case report. J Bone Joint Surg Am. 1997;79:1552–1555.PubMed
26.
Pandeli C, Gotia DG, Filip F, Pandeli R. [The importance of Dunn’s procedure in the treatment of slipped femoral epiphysis.][Article in Romanian]. Rev Med Chir Soc Med Nat Iasi. 2003;107:831–833.PubMed
27.
Parsch K, Zehender H, Bühl T, Weller S. Intertrochanteric corrective osteotomy for moderate and severe chronic slipped capital femoral epiphysis. J Pediatr Orthop B. 1999;8:223–230.PubMed
28.
Rappaport EB, Fife D. Slipped capital femoral epiphysis in growth hormone-deficient patients. Am J Dis Child. 1985;139:396–399PubMed
29.
Rosenthal AK, Heinkel D, Gohr CM. Thyroxine stimulates transglutaminase activity in articular chondrocytes. Osteoarthritis Cartilage. 2003;11:463–470.PubMedCrossRef
30.
Schai PA, Exner GU. Indication for and results of intertrochanteric osteotomy in slipped capital femoral epiphysis. Orthopade. 2002;31:900–907.PubMedCrossRef
31.
Szypryt EP, Clement DA, Colton CL. Open reduction or epiphysiodesis for slipped upper femoral epiphysis: a comparison of Dunn’s operation and the Heyman-Herndon procedure. J Bone Joint Surg Br. 1987;69:737–742.PubMed
32.
Tillema DA, Golding JS. Chondrolysis following slipped capital femoral epiphysis in Jamaica. J Bone Joint Surg Am. 1971;53:1528–1540.PubMed
33.
Unnikrishnan AG, Agrawal NK, Reddy DV, Kumar R, Singh SK. Gigantism associated with slipped capital femoral epiphysis. J Assoc Physicians India. 2003;51:826–827.PubMed
34.
Vrettos BC, Hoffman EB. Chondrolysis in slipped upper femoral epiphysis: long-term study of the aetiology and natural history. J Bone Joint Surg Br. 1993;75:956–961.PubMed
35.
Vukasinović Z, Slavković N, Slavković S. [Complications of slipped capital femoral epiphysis.][Article in Serbian]. Srp Arh Celok Lek. 2007;135:105–110.PubMed
36.
Warner WC Jr, Beaty JH, Canale ST. Chondrolysis after slipped capital femoral epiphysis. J Pediatr Orthop B. 1996;5:168–172.PubMed
37.
Weiner D. Pathogenesis of slipped capital femoral epiphysis: current concepts. J Pediatr Orthop B. 1996;5:67–73.PubMed
38.
Wells D, King JD, Roe TF, Kaufman FR. Review of slipped capital femoral epiphysis associated with endocrine disease. J Pediatr Orthop. 1993;13:610–614.PubMed
39.
Wilson PD, Jacobs B, Schecter L. Slipped capital femoral epiphysis: an end-result study. J Bone Joint Surg Am. 1965;47:1128–1145.PubMed
Metadata
Title
Case Report
Bilateral Slipped Capital Femoral Epiphyses and Hormone Replacement
Authors
Ali Nourbakhsh, MD
Hasan A. Ahmed, MCh Orth, FRCS (Tr & Orth)
Thomas B. McAuliffe, MA, FRCS
Kim J. Garges, MD
Publication date
01-03-2008
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 3/2008
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-007-0099-x

Other articles of this Issue 3/2008

Clinical Orthopaedics and Related Research® 3/2008 Go to the issue

Symposium: New Approaches to Shoulder Surgery

Contribution of the Reverse Endoprosthesis to Glenohumeral Kinematics

Original Article

Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty

Symposium: Tribute to Dr. Anthony F. DePalma, First Editor-in-Chief of Clinical Orthopaedics and Related Research

Loss of Scapulohumeral Motion (Frozen Shoulder)

Symposium: New Approaches to Shoulder Surgery

Biological Augmentation of Rotator Cuff Tendon Repair

Symposium: New Approaches to Shoulder Surgery

New Approaches to Shoulder Surgery

Case Report

Case Report