SLIPPED CAPITAL FEMORAL EPIPHYSIS ASSOCIATED WITH ENDOCRINE DISORDERS

We reviewed 85 patients with endocrine disorders and slipped capital femoral epiphysis (SCFE). The disorders were hypothyroidism (40%), growth hormone deficiency (25%), and others (35%). The average age at diagnosis of the disorder was 13.2 +/- 6.2 years and 15.3 +/- 5.3 years at diagnosis of the first SCFE. In 53 hips, the bone and chronologic age were both known: 11.6 +/- 3.0 years bone age, 16.5 +/- 6.5 years chronologic age, p < 0.01. The age at presentation of the first SCFE ranged from 7-35 years; only those with hypothyroidism or growth hormone deficiency were <10 years of age; all patients with other endocrinopathies, when seen first with an SCFE at an atypical age, were >16 years. The hypothyroid patients usually had the endocrine diagnosis made at presentation of the first SCFE; the growth hormone-deficient children usually had the endocrine diagnosis made before that of the SCFE (p < 0.01). None of those in whom the diagnosis of the endocrine disorder occurred after the diagnosis of the SCFE was hypothyroid or growth hormone deficient. All hypothyroid patients developed the first SCFE before or during hormonal supplementation; 92% with growth hormone deficiency developed the SCFE during or after supplementation (p < 0.01). Because the prevalence of bilaterality was 61% (p < 0.01), prophylactic treatment of the opposite hip should be considered.