Case report of slipped capital femoral epiphysis combined with primary hyperparathyroidism
10.3760/cma.j.cn101070-20240106-00007
- VernacularTitle:原发性甲状旁腺功能亢进症合并股骨头骨骺滑脱1例
- Author:
Wendong LIU
1
;
Fuyong ZHANG
;
Xiaodong WANG
;
Mincheng ZOU
Author Information
1. 苏州大学附属儿童医院骨科，苏州 215000
- Keywords:
Slipped capital femoral epiphysis;
Primary hyperparathyroidism;
Choice of treatment
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(9):694-696
- CountryChina
- Language:Chinese
-
Abstract:
Clinical data of a teenager with slipped capital femoral epiphysis (SCFE) combined with primary hyperparathyroidism (PHPT) treated in the Children′s Hospital of Soochow University in May 2022 were retrospectively analyzed.A girl, aged 13 years and 5 months, had claudication of both lower limbs for 1.5 years, and the symptom was aggravated for 1 month.X-ray examination of the hip joint showed bilateral SCFE.However, the patient had a body mass index of 18.2 kg/m 2 and no trauma, which did not meet the typical characteristics of SCFE.Further ultrasound examination of the parathyroid gland shows parathyroid adenoma.And parathyroid adenoma was considered to cause PHPT, which in turn triggered SCFE.After surgical resection of the PHPT, the patient had a better fusion of the femoral head and femoral neck and improved hip joint function.Therefore, SCFE fixation was not performed.The diagnosis and treatment of this patient indicated that for similar patients with SCFE and PHPT, SCFE may not be treated with internal fixation, if the femoral head and femoral neck have been fused, the hip joint function has improved, and the pain has been relieved after resection of PHPT.In patients with SCFE and PHPT, the management of hyperparathyroidism takes precedence over the treatment of SCFE.Acute and acute-on-chronic slip, with or without PHPT-induced hypercalcemia, should be treated first by SCFE fixation, and excising parathyroid adenoma should be performed simultaneously or as soon as possible.For chronic slip patients who have mild to moderate hypercalcemia and one or more related symptoms, parathyroidectomy should be performed firstly, and then the SCFE fixation should be considered after parathyroid hormone and blood calcium levels become stable.
