Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case...

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Main Authors: Yoshihiro Kotoura, Yasuhiro Fujiwara, Tatsuro Hayashida, Koji Murakami, Satoshi Makio, Yuichi Shimizu, Yoshinobu Oka, Wook-Choel Kim, Taku Ogura, Toshikazu Kubo
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2017/8981250
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author Yoshihiro Kotoura
Yasuhiro Fujiwara
Tatsuro Hayashida
Koji Murakami
Satoshi Makio
Yuichi Shimizu
Yoshinobu Oka
Wook-Choel Kim
Taku Ogura
Toshikazu Kubo
author_facet Yoshihiro Kotoura
Yasuhiro Fujiwara
Tatsuro Hayashida
Koji Murakami
Satoshi Makio
Yuichi Shimizu
Yoshinobu Oka
Wook-Choel Kim
Taku Ogura
Toshikazu Kubo
author_sort Yoshihiro Kotoura
collection DOAJ
description Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.
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spelling doaj-art-30706fd6d18d4fd894d0e18ecd96e4c72025-08-20T02:07:53ZengWileyCase Reports in Orthopedics2090-67492090-67572017-01-01201710.1155/2017/89812508981250Valgus Slipped Capital Femoral Epiphysis in Patient with HypopituitarismYoshihiro Kotoura0Yasuhiro Fujiwara1Tatsuro Hayashida2Koji Murakami3Satoshi Makio4Yuichi Shimizu5Yoshinobu Oka6Wook-Choel Kim7Taku Ogura8Toshikazu Kubo9Department of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Orthopaedic Surgery, Nantan General Hospital, Nantan, JapanDepartment of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanSlipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.http://dx.doi.org/10.1155/2017/8981250
spellingShingle Yoshihiro Kotoura
Yasuhiro Fujiwara
Tatsuro Hayashida
Koji Murakami
Satoshi Makio
Yuichi Shimizu
Yoshinobu Oka
Wook-Choel Kim
Taku Ogura
Toshikazu Kubo
Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism
Case Reports in Orthopedics
title Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism
title_full Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism
title_fullStr Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism
title_full_unstemmed Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism
title_short Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism
title_sort valgus slipped capital femoral epiphysis in patient with hypopituitarism
url http://dx.doi.org/10.1155/2017/8981250
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