Slipped Capital Femoral Epiphysis in an Adult with Panhypopituitarism

CASE: Our patient was a 31-year-old woman with previously undiagnosed panhypopituitarism who presented with bilateral slipped capital femoral epiphysis (SCFE). Together with endocrinology, her treatment plan involved medical management of her panhypopituitarism and surgical correction with femoral neck osteotomy. Hormone deficiencies were corrected 6 weeks after replacement therapy began, and the patient was cleared for surgery. By 5 months after osteotomy, examination revealed delayed union and prominent screws bilaterally. Hardware exchange and repeat internal fixation were then performed. At 8 weeks after revision, she presented with avascular necrosis, and the decision was made to proceed with total hip arthroplasty. A 5-year follow-up period was documented. CONCLUSION: This case presented a rare look at SCFE in an adult patient with panhypopituitarism. Other systemic illnesses that can contribute to SCFE or other orthopaedic issues include, but are not limited to, multiple endocrine neoplasia syndromes, vitamin D deficiency, renal osteodystrophy, Kallmann syndrome, Klinefelter syndrome, and pathologies affecting the thyroid and pituitary gland.