Supplement| September 01 1999 SECTION ON ORTHOPAEDICS 1999 ANNUAL MEETING October 9-10, 1999 Robert B. Cady, MD Robert B. Cady, MD Program Chair Search for other works by this author on: This Site PubMed Google Scholar Pediatrics (1999) 104 (Supplement_4): 706–725. https://doi.org/10.1542/peds.104.S4.706 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Robert B. Cady; SECTION ON ORTHOPAEDICS 1999 ANNUAL MEETING October 9-10, 1999. Pediatrics September 1999; 104 (Supplement_4): 706–725. 10.1542/peds.104.S4.706 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP Grand RoundsAAP NewsAll AAP Sites Search Advanced Search Topics: orthopedics This content is only available via PDF. American Academy of Pediatrics1999 Article PDF first page preview Close Modal You do not currently have access to this content.
Slipped capital femoral epiphysis (SCFE) is a serious developmental hip disorder that is often mistaken for one of the more frequently seen benign lower extremity conditions. The problem is more common in boys than girls, and occurs during adolescence, with a peak age of 13 1/2 in boys and 11 1/2 in girls. Early diagnosis of SCFE is extremely important, as treatment at that time is usually simple and the outcome satisfactory. The capital femoral epiphysis (femoral head) is the secondary ossification center of the proximal femur. It is separated from the metaphysis (femoral neck) by the physis (growth plate, epiphyseal plate).
A 14-year-old boy with a posterior dislocation of the femoral head suffered an epiphyseal separation with reduction of the femoral neck into the acetabulum during an attempted closed reduction. He was treated by an open reduction with care taken not to damage the retinacular blood supply to the head. He did not develop avascular necrosis and is totally asymptomatic four years following his injury.
Although the usual etiology of slipped capital femoral epiphysis (SCFE) is idiopathic, there are many underlying endocrinologic, biomechanical, metabolic, and connective tissue abnormalities that increase the predisposition to slippage. Four case reports and a review of the literature demonstrate tht hypopituitarism, renal rickets, radiation therapy, hypoestrogenic states, and chemotherapy can be associated with SCFE. Awareness of the variety of conditions under which SCFE can occur is an important factor in providing early diagnosis, since many patients undergo slippage at atypical ages. In metabolically and endocrinologically abnormal patients, surgical stabilization may need to be augmented by autologous bone grafting to ensure successful epiphyseodesis.
Outpatient pediatric orthopedic records were reviewed retrospectively in an attempt to identify all patients with congenital spine and urinary tract anomalies. All patients with a positive intravenous pyelogram (IVP) were asked to return for ultrasonographic evaluation. Urinary tract abnormalities were identified in seven (26%) of the 27 patients with documented IVPs. An additional patient was later added to the series, making a total of seven patients who returned for an ultrasonogram, which was then compared with the IVP. Observations and a review of the literature suggest that ultrasonography combined with urinalysis and serum creatinine is the screening protocol of choice in this patient population.
