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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 5, 666-669.
doi: 10.1302/0301-620X.91B5.22160  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Slipped upper femoral epiphysis in Hashimoto’s thyroiditis in a 29-year-old man

A. T. Oommen, MS(Ortho), DNB(Orth), Assistant Professor1; V. Madhuri, MS(Ortho), MCh(Ortho), Professor and Head1; and T. V. Paul, MDMed, DNB(Endocrinology), Assistant Professor2

1 Department of Orthopaedics
2 Department of Endocrinology Christian Medical College and Hospital, Vellore 632004, Tamil Nadu, India.

Correspondence should be sent to Dr A. T. Oommen; e-mail: lillyanil{at}cmcvellore.ac.in

Slipped upper femoral epiphysis (SUFE) with an open physis is rare in an adult and the condition may present without prior diagnosis of an underlying medical condition. We have treated a 29-year-old man with bilateral SUFE associated with autoimmune hypothyroidism. The management was delayed and complicated by co-existing autoimmune chronic active hepatitis. He underwent thyroxine therapy and bilateral pinning in situ with a single ASNIS screw. Closure of the physis occurred after five months on the right side. The left side required a further corrective intertrochanteric osteotomy, and it was only after 13 months that complete fusion of this physis was seen. The case highlights the need to consider endocrine and metabolic conditions in atypical presentation of SUFE.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General