Prepubertal onset of slipped capital femoral epiphysis associated with hypothyroidism: a case report and literature review.

Abstract

BACKGROUND:

Slipped capital femoral epiphysis (SCFE) is a common hip disorder characterized by displacement of the capital femoral epiphysis from the metaphysic through the femoral epiphyseal plate. SCFE usually occurs during puberty, with obesity a common risk factor. We experienced a rare case of SCFE associated with hypothyroidism in a prepubescent patient who was not obese.

CASE PRESENTATION:

The patient was an 8-year-old boy suffering from bilateral SCFE with hypothyroidism. The patient's growth had started to slow at 4 years of age, and at 8 years he was of short stature. During his evaluation for SCFE management, primary hypothyroidism was diagnosed due to the presence of anti-thyroid peroxidase and anti-thyroglobulin antibodies. After the patient was treated for hypothyroidism, which improved his thyroid function, surgery was performed for bilateral SCFE.

CONCLUSIONS:

Among the 42 patients with SCFE associated with hypothyroidism in the literature, most SCFE occurred during puberty or in adults with delayed epiphyseal closure. Only two patients (4.8%), including the present patient, were ≤9 years old. Although being overweight or obese is common for patients with SCFE associated with hypothyroidism (76.0%), it was not observed in the present case. Persistent hypothyroidism, however, may be a risk factor for SCFE even before puberty and without obesity.

• Authors: Saori Kadowaki, Tomohiro Hori, Hideki Matsumoto, Kaori Kanda, Michio Ozeki, Yu Shirakami, Norio Kawamoto, Hidenori Ohnishi, Toshiyuki Fukao
• Journal: BMC endocrine disorders (BMC Endocr Disord) Vol. 17 Issue 1 Pg. 59 (Sep 18 2017) ISSN: 1472-6823 [Electronic] England
• PMID: 28923047 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Body Weight
• Child
• Humans
• Hypothyroidism (complications, diagnosis, pathology)
• Male
• Risk Factors
• Slipped Capital Femoral Epiphyses (diagnostic imaging, etiology, pathology)