Loder R T, Wittenberg B, DeSilva G
Section of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA.
J Pediatr Orthop. 1995 May-Jun;15(3):349-56. doi: 10.1097/01241398-199505000-00018.
We reviewed 85 patients with endocrine disorders and slipped capital femoral epiphysis (SCFE). The disorders were hypothyroidism (40%), growth hormone deficiency (25%), and others (35%). The average age at diagnosis of the disorder was 13.2 +/- 6.2 years and 15.3 +/- 5.3 years at diagnosis of the first SCFE. In 53 hips, the bone and chronologic age were both known: 11.6 +/- 3.0 years bone age, 16.5 +/- 6.5 years chronologic age, p < 0.01. The age at presentation of the first SCFE ranged from 7-35 years; only those with hypothyroidism or growth hormone deficiency were < 10 years of age; all patients with other endocrinopathies, when seen first with an SCFE at an atypical age, were > 16 years. The hypothyroid patients usually had the endocrine diagnosis made at presentation of the first SCFE; the growth hormone-deficient children usually had the endocrine diagnosis made before that of the SCFE (p < 0.01). None of those in whom the diagnosis of the endocrine disorder occurred after the diagnosis of the SCFE was hypothyroid or growth hormone deficient. All hypothyroid patients developed the first SCFE before or during hormonal supplementation; 92% with growth hormone deficiency developed the SCFE during or after supplementation (p < 0.01). Because the prevalence of bilaterality was 61% (p < 0.01), prophylactic treatment of the opposite hip should be considered.
我们回顾了85例患有内分泌疾病及股骨头骨骺滑脱（SCFE）的患者。这些疾病包括甲状腺功能减退（40%）、生长激素缺乏（25%）以及其他（35%）。内分泌疾病诊断时的平均年龄为13.2±6.2岁，首次诊断SCFE时的平均年龄为15.3±5.3岁。在53个髋关节中，骨龄和实际年龄均已知：骨龄为11.6±3.0岁，实际年龄为16.5±6.5岁，p<0.01。首次出现SCFE的年龄范围为7至35岁；只有甲状腺功能减退或生长激素缺乏的患者年龄小于10岁；所有患有其他内分泌疾病且在非典型年龄首次出现SCFE的患者年龄均大于16岁。甲状腺功能减退患者通常在首次出现SCFE时确诊内分泌疾病；生长激素缺乏的儿童通常在内分泌疾病的诊断早于SCFE（p<0.01）。在内分泌疾病诊断发生在SCFE诊断之后的患者中，没有甲状腺功能减退或生长激素缺乏的患者。所有甲状腺功能减退患者在激素补充之前或期间出现首次SCFE；92%生长激素缺乏的患者在补充期间或之后出现SCFE（p<0.01）。由于双侧患病率为61%（p<0.01），应考虑对另一侧髋关节进行预防性治疗。
