Título: Diagnóstico oportuno de epifisiolistesis de cadera en pacientes de edad transicional. Estudio realizado en el área de traumatología del Hospital del Niño . Ginnette M. Martínez L. EPIFISIOLISIS DE CADERA Desplazamiento progresivo o rápido de la epífisis femoral superior. Puede afectar a. EPIFISIOLISIS AGUDA DE CADERA DCHA. Done. Comment. views. 0 faves. 0 comments. Taken on October 29, All rights reserved.
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This is a year-old boy, born at term with adequate weight for gestational age. At 12 year, 11 months of age, after a diagnosis of bilateral slipped capital femoral epiphysis was made. He required surgical correction hip osteotomy and fixation with right hip xadera.
Unfortunately, follow up was not favorable and he was admitted again because of left hip luxation.
EPIFISIOLISIS CADERA DERECHA
Weight 53 Kg 0. Because of his obesity, he was then referrer to the Nutrition and to the Endocrinology Services of Hospital de Pediatria Garrahan. At initial physical examination, we observed a prostrate patient with a blunt fascies, and myxedema with significant generalized xerosis. The thyroid gland was firm at palpation, but no cervical adenopathy was detected. Since clinical signs, strongly suggested severe hypothyroidism the following laboratory worked up was ordered: Results show Severe Primary Hypothyroidism secondary to autoimmnunity, as well as hypercholesterolemia and anemia Tables.
EPIFISIOLISIS AGUDA DE CADERA DCHA
He also had normal serum ACTH, as well as pre-pubertal serum gonadotropins and testosterone, compatible with the clinical findings. Testis volumes, however, were increased, as reported in macro-orchidism secondary to hyper-thyroidotropinism without virilization.
In order to complete studies in this patient with severe hypothyroidism and bilateral hip epiphysiolysis we ordered the following: Slipped capital femoral epiphysis SCFE is a hip condition that occurs in teens and pre-teens who are still growing. For reasons that are not well understood, the ball at the head of the femur epifisiolistseis slips off the neck of the bone in a backward direction.
This causes pain, stiffness, and instability in the affected hip. The condition usually develops gradually over time and is more common in boys than in girls.
Deslizamiento de la epífisis capital femoral (SCFE, o epifisiolisis) (para Padres)
Hip epiphysiolisis slipped capital femoral epiphysis, SCFE is the gradual and rotative pathologic displacement of the growth plate in the proximal femur epiphysis 1 The average age of presentation is 13,5 years in boys and 12 years in girls 2. It is more re in boys and it is associated with overweight and hypothyroidism 3. Thyroid hormones play a fundamental role, direct and indirect, in bone metabolism and healing 4.
T3 acts in the process of chondrocyte maturation in the growth plate, and it also has an important role in the interstitial matrix favoring the synthesis of type II collagen 5.
Several reports suggest that thyroid disorders should be screened in patients with atypical presentations, such us below 10 years or above 16 years of age, bilateral SCFE, and stunted growth 1, 6, 7. Moreover, severe hypothyroidism favors delays in healing and lack of joint union.
EPIFISIOLISIS AGUDA DE CADERA DCHA | Jorge Hodgson | Flickr
Adequate treatment and euthyroidism favour a favorable clinical evolution. These patients should be diagnosed early, and furthermore, they should be managed by an interdisciplinary team.
P Garrahan, Buenos Aires, Argentina At left, in bilateral displacements of the capital femoral over the growth plate is observed with discrete widening of both femoral necks, left predominance. Dislocation of the left hip — General decreased of bone density Clinical Case This is a year-old boy, born at term with adequate weight for gestational age.
Testis ultrasound showed two scrotal testes of normal prepubertal size, and normal epididymis. Surgical intervention was postponed until normalization of thyroid function, anemia, and metabolic profile.
Patient received 48 h. Levothyroxine dose was gradually increased until euthyroidism was reached. Definitive surgical correction of hip displacement was then carried wpifisiolistesis.
One month later, patient was finally discharged. Outpatient control recommendation was indicated.
Comments Slipped capital femoral epiphysis SCFE is a hip condition that occurs in teens and pre-teens who are still growing. Slipped capital femoral epiphysis and associated hypothyroidism. A review of the literature with two classic case examples.
The demographics of slipped capital femoral epiphysis. An international multicenter study. Clin Orthop ; Endocrine disorders and orthopedic problems in children. Current opinion in pediatrics ; 8: Arch Biochem Biophys ; Slipped capital femoral epiphysis associated with endocrine disorders. J Pediatr Orthop ; Heyerman W, Weiner D.
Slipped epiphysis associated with hypothyroidism. J Pediatr Orthop ; 4: Growth hormone levels in slipped capital femoral epiphsys. J Bone Joint Surg Am ; Endocrinologic and metabolic factors in atypical presentations of slipped capital femoral epiphysis. Report of four cases and review of the literature.