• Title/Summary/Keyword: Slipped capital femoral epiphysis

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Slipped Capital Femoral Epiphysis Associated with Hypopituitarism in Patients over 20 Years (20세 이상의 뇌하수체 기능 저하증에 의한 대퇴골두 골단분리증)

  • Na, Seung Min;Kim, Yong Uk;Cho, Yong Jin;Jung, Sung Taek
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.567-573
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    • 2019
  • Slipped capital femoral epiphysis (SCFE) is a rare disorder of the proximal femur in adolescents. The pathogenesis of SCFE is unclear, but it is believed to be the result of a mechanical insufficiency of the proximal femur physis. SCFE appears to caused by mechanical, endocrinal, and immunological abnormalities. Few cases have reported the SCFE associated with endocrine disorder in the domestic literature, particularly in patients over 20 years old. This paper reports two cases of SCFE associated with hypopituitarism in adults over 20 years old.

Panhypopituitarism due to craniopharyngioma with bilateral slipped capital femoral epiphysis (두개인두종 치료 후 발생한 범뇌하수체기능저하증과 동반된 양측 대퇴골두골단분리증)

  • Kim, Sun Woo;Song, Young-Jin;Choi, Eun Jeong;Han, Dong Hee;Jung, Hyun Yon;Yu, Sung Hoon;Yoo, Hyung Joon;Yu, Jae Myung
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.61-64
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    • 2014
  • Craniopharyngiomas are rare primary intracranial tumors. Despite their benign histological appearance, they are often associated with an unfavorable prognosis. The typical manifestations upon diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, disturbance of pubertal development, and significant weight gain. The treatment options include radical surgery or radiotherapy, or a combination of these modalities. Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder. SCFE occurs when the capital femoral epiphysis displaces posteriorly on the femoral neck at the level of the physis. The etiology of SCFE is thought to be multifactorial and may include obesity, growth surges, and less common endocrine disorders. The related endocrine disorders include hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Reported herein is a case of panhypopituitarism caused by craniopharyngioma combined with SCFE.

Physeal Remodeling after Internal Fixation of Slipped Capital Femoral Epiphysis (대퇴골두골단분리증 환자 중 금속내고정술을 시행받은 환자에서의 골단판의 재형성)

  • Kim, Se-Dong;Park, Byung-Won
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.28-35
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    • 2003
  • Purpose: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. Materials and Methods: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal-shaft angle. Results: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, $7.8^{\circ}$), in 2 patients (3 hips) at group II (mean, $10.7^{\circ}$). Conclusion: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.

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Spontaneous Femoral Capital Physeal Fracture with Proximal Tibial Epiphyseal Dysplasia in a Cat

  • Yoo, Saejong;Kim, Dae-Hyun;Lee, Yunsub;Yeo, Seungyeob;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.112-115
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    • 2019
  • An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.

Pediatric Hip Disorders (소아 고관절 질환)

  • Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon;Seul Bi Lee;Yeon Jin Cho
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.531-548
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    • 2024
  • Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

Slipped Capital Femoral Epiphysis(SCFE) (대퇴골두 골단분리증의 치험례)

  • Dan, Jin-Myoung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.245-261
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    • 1997
  • Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

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Usefulness of Bone SPECT/CT for Predicting Avascular Necrosis of the Femoral Head in Children with Slipped Capital Femoral Epiphysis or Femoral Neck Fracture

  • Yoo Sung Song;Won Woo Lee;Moon Seok Park;Nak Tscheol Kim;Ki Hyuk Sung
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.264-270
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    • 2022
  • Objective: This study aimed to investigate the usefulness of bone single-positron emission tomography/computed tomography (SPECT/CT) of the hip in predicting the later occurrence of avascular necrosis (AVN) after slipped capital femoral epiphysis (SCFE) or femoral neck fracture in pediatric patients. The quantitative parameters of SPECT/CT useful in predicting AVN were identified. Materials and Methods: Twenty-one (male:female, 10:11) consecutive patients aged < 18 years (mean age ± standard deviation [SD], 11.0 ± 2.7 years) who underwent surgery for SCFE or femoral neck fracture and postoperative bone SPECT/CT were included. The maximum standardized uptake value (SUV), mean SUV, and minimum SUV of the femoral head were measured. The ratios of the maximum SUV, mean SUV, and minimum SUV of the affected femoral head to the contralateral side were determined. Patients were followed up for > 1 year after the surgery. The SPECT/CT parameters were compared between patients who developed AVN and those who did not. The accuracy of SPECT/CT parameters for predicting AVN was assessed. Results: Six patients developed AVN. There was a significant difference in the ratio of the mean SUV among patients who developed AVN (mean ± SD, 0.8 ± 0.3) and those who did not (1.1 ± 0.2, p = 0.018). However, there were no significant differences in the ratios of the maximum and minimum SUV between the groups (all p = 0.205). For the maximum, mean, and minimum SUVs, no significant differences were observed between the groups (p = 0.519, 0.733, and 0.470, respectively). The cutoff mean SUV ratio of 0.87 yielded a 66.7% sensitivity and 93.2% specificity for predicting AVN. Conclusion: Quantitative bone SPECT/CT is useful for evaluating femoral head viability in pediatric patients with SCFE or femoral neck fractures. Clinicians should consider the high possibility of later AVN development in patients with a decreased mean SUV ratio.