Review of slipped capital femoral epiphysis associated with endocrine disease

Abstract

Review of type and bilaterality of 131 cases (40 bilateral) of slipped capital femoral epiphysis (SCFE) in patients with known endocrinopathies (hypothyroidism, panhypopituitarism, hypogonadism) from 1960 to 1990 showed an increased frequency of patients with endocrine disorders, primarily hypothyroidism (nine of 131 patients, 6.9%); three had bilateral slips; six developed bilateral slips in an average of 11.17 months. Delayed growth plate closure is common in SCFE. Because hypothyroidism can be easily overlooked, all patients with SCFE should be screened for hypothyroidism by measuring serum T4 and TSH (such screening is inexpensive (r = $60). Pituitary deficiency should be considered in children short for their age who have hypogonadism. Any child with a unilateral slip and one of these endocrine deficiencies has a high risk of subsequent bilateral involvement. Prophylactic pinning of the uninvolved hip is recommended because 100% of our patients eventually had bilateral slips.