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Primary hyperparathyroidism presenting as slipped capital femoral epiphysis
  1. Gautam Kumar1,
  2. Vivek Mathew2,
  3. Julio Chacko Kandathil3,
  4. Bipin Theruvil1
  1. 1 Orthopaedics, VPS Lakeshore Hospital and Research Centre, Kochi, India
  2. 2 Endocrinology, VPS Lakeshore Hospital and Research Centre, Kochi, India
  3. 3 Radiology, VPS Lakeshore Hospital and Research Centre, Kochi, India
  1. Correspondence to Dr Bipin Theruvil, Department of Orthopaedics, VPS Lakeshore Hospital, Kochi, India; theruvil{at}gmail.com

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A 15-year-old boy presented with insidious onset bilateral thigh pain for 6 months. Examination of hips showed restricted internal rotation. Pelvis radiograph (figure 1) showed bilateral slipped capital femoral epiphysis (SCFE) with subchondral bone resorption in right inferior pubic rami and ilium . Hand radiograph (figure 2) showed subperiosteal bone resorption along the radial aspect of middle phalanges.

Figure 1

Anteroposterior view of pelvis shows whole epiphysis lying inferior to the line (Klein’s line) suggestive of SCFE. In normal hip, one-third of physis should be above the line. Subperiosteal resorption along the ilium (black arrow) …

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Footnotes

  • Contributors The first author (GK) wrote the manuscript and was involved in the clinical management of the patient.The second author (VM) was involved in writing the manuscript and managed the endocrinological aspect of treatment. The third author (JCK) reviewed the radiological investigations and reported the findings for the manuscript. The final author (BT) was involved in writing the manuscript. The patient was admitted under his care and he performed the surgery.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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