Endocrine dysfunction and slipped captial femoral epiphysis

Area of Science:

• Pediatric Endocrinology
• Orthopedic Surgery
• Developmental Biology

Background:

• Slipped capital femoral epiphysis (SCFE) is a hip condition affecting adolescents.
• Endocrinopathies are increasingly recognized as a potential contributing factor to SCFE.
• Craniopharyngioma is a rare brain tumor that can lead to hormonal deficiencies.

Observation:

• Five patients with both endocrinopathy and SCFE were analyzed, presenting with conditions including diabetes, hypothyroidism, hypergonadotropic hypogonadism, and craniopharyngioma with panhypopituitarism.
• Seven additional patients with craniopharyngioma showed delayed epiphyseal closure, and one had undiagnosed SCFE.
• Histological examination of a femoral head from a child with panhypopituitarism revealed growth plate irregularities, suggesting a predisposing factor for SCFE in endocrinopathic children.

Findings:

• Hormonal imbalances associated with endocrinopathies, including hypothyroidism and panhypopituitarism, are implicated in the etiology of SCFE.
• Delayed epiphyseodesis (epiphyseal fusion) was observed in patients with SCFE and endocrinopathies, necessitating bone grafting during surgical stabilization.
• Growth plate irregularities and loss of columnar integrity in the physis may predispose children with endocrinopathies to SCFE.

Implications:

• Understanding the hormonal influences on the physis is crucial for diagnosing and managing SCFE in endocrinopathic patients.
• Early identification and treatment of hormonal imbalances may help prevent SCFE or mitigate its severity.
• This study highlights the importance of a multidisciplinary approach involving endocrinologists and orthopedic surgeons for affected children.