Slipped capital femoral epiphysis following radiotherapy and chemotherapy

There may be an increased frequency of slipped femoral epiphysis in pediatric patients who have received radiation to the pelvic area and combination chemotherapy. Previous reports include bilateral slipping of the epiphysis, eight years after radiation, in a patient with a pelvic neuroblastoma and the occurrence in a patient who had received radiation for Hodgkin disease, with a primary site in the pelvic region. No direct correlation was established in either case. This is a report of two patients who received pelvic radiation and combination chemotherapy who subsequently developed slipped femoral epiphysis. Our purpose is to heighten the suspicion in patients who have received radiation and chemotherapy for pelvic tumors. It is recommended that the femoral heads and acetabula be shielded when their inclusion in the treatment fields is not crucial to the treatment of the underlying disease.