Case Reports
Delayed-Onset Slipped Capital Femoral Epiphysis: Case Report of Association With Pituitary Tumor
Am J Orthop. 2010 March;39(3):137-140
Author and Disclosure Information
Robert L. Brady, MD, and Andrew Price, MD
Dr. Brady is Attending, Department of Orthopaedic Surgery, Norwalk Hospital, Norwalk, Connecticut. At the time of manuscript submission, he was Resident, Department of Orthopaedic Surgery, St. Lukes-Roosevelt Hospital Center, New York, New York.
Dr. Price is Attending, Department of Orthopaedic Surgery, St. Lukes-Roosevelt Hospital Center, New York, New York; Associate Professor of Orthopaedic Surgery, Columbia University, New York, New York; Attending, Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York, New York; and Clinical Associate Professor of Orthopaedic Surgery, New York University, New York, New York.
Slipped capital femoral epiphysis (SCFE) is an affliction of the hip presenting in adolescent children. There are several theories regarding the pathological cause of SCFE. The hormonal milieu during adolescence, combined with a deficiency in the physeal area of the growth plate, has been postulated as a possible etiology for its specific onset. In atypical circumstances, the early or late onset of SCFE may occur in the setting of unusual hormonal influences. This hormonal imbalance may be secondary to an underlying endocrinopathy—for example, hypothyroidism or hypogonadism.
In this case, our patient presented with a clinically and radiographically unstable slip at the age of 22 years. His physical characteristics, along with confirmatory laboratory values and radiographs, indicated that the patient suffered from a disorder of delayed secondary growth. Subsequent thorough work-up revealed a large benign pituitary tumor that was causing severe panhypopituitarism.
This article describes the presentation, diagnostic work-up and treatment of our patient with a delayed-onset SCFE in the setting of a pituitary tumor.