Approach to the management of slipped capital femoral epiphysis and primary hyperparathyroidism
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Approach to the management of slipped capital femoral epiphysis and primary hyperparathyroidism. / El Scheich, Tarik; Marquard, Jan; Westhoff, Bettina; Schneider, Axel; Cupisti, Kenko; Oh, Jun; Meissner, Thomas; Mayatepek, Ertan; Klee, Dirk.
In: J PEDIATR ENDOCR MET, Vol. 25, No. 3-4, 2012, p. 239-44.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Approach to the management of slipped capital femoral epiphysis and primary hyperparathyroidism
AU - El Scheich, Tarik
AU - Marquard, Jan
AU - Westhoff, Bettina
AU - Schneider, Axel
AU - Cupisti, Kenko
AU - Oh, Jun
AU - Meissner, Thomas
AU - Mayatepek, Ertan
AU - Klee, Dirk
PY - 2012
Y1 - 2012
N2 - CONTEXT: Worldwide, only nine cases of slipped capital femoral epiphysis (SCFE) associated with primary hyperparathyroidism (PHP) have been reported.CASE ILLUSTRATION: This is a report on adolescent subjects with SCFE associated with PHP exhibiting the leading pathogenesis and clinical course.METHODS: Here, we reviewed all known cases and developed an effective approach to the management of SCFE and PHP.RESULTS: In cases of emergency, SCFE fixation is primarily done regardless of any preexistent hypercalcemia due to PHP and is followed by parathyroidectomy as soon as possible. In cases of mild and moderate hypercalcemia, whether SCFE fixation is followed by parathyroidectomy and vice versa or resolved during a single operating session depends on the side effects of hypercalcemia. Severely hypercalcemic patients should undergo urgent parathyroidectomy followed by immediate orthopedic surgery or even as a simultaneous procedure. This is to avoid onset of hypercalcemic side effects or worsening of preexisting side manifestations resulting from hypercalcemia.CONCLUSION: Our report demonstrates that SCFE patients presenting with hypercalcemia, signs of low bone density, or with non-typical age of onset deserve further workup for secondary causes. In addition, the newly developed systematic approach toward achieving an effective, efficient management should help in improving the patients' long-term outcome.
AB - CONTEXT: Worldwide, only nine cases of slipped capital femoral epiphysis (SCFE) associated with primary hyperparathyroidism (PHP) have been reported.CASE ILLUSTRATION: This is a report on adolescent subjects with SCFE associated with PHP exhibiting the leading pathogenesis and clinical course.METHODS: Here, we reviewed all known cases and developed an effective approach to the management of SCFE and PHP.RESULTS: In cases of emergency, SCFE fixation is primarily done regardless of any preexistent hypercalcemia due to PHP and is followed by parathyroidectomy as soon as possible. In cases of mild and moderate hypercalcemia, whether SCFE fixation is followed by parathyroidectomy and vice versa or resolved during a single operating session depends on the side effects of hypercalcemia. Severely hypercalcemic patients should undergo urgent parathyroidectomy followed by immediate orthopedic surgery or even as a simultaneous procedure. This is to avoid onset of hypercalcemic side effects or worsening of preexisting side manifestations resulting from hypercalcemia.CONCLUSION: Our report demonstrates that SCFE patients presenting with hypercalcemia, signs of low bone density, or with non-typical age of onset deserve further workup for secondary causes. In addition, the newly developed systematic approach toward achieving an effective, efficient management should help in improving the patients' long-term outcome.
KW - Adolescent
KW - Disease Management
KW - Humans
KW - Hyperparathyroidism, Primary/complications
KW - Male
KW - Slipped Capital Femoral Epiphyses/diagnosis
M3 - SCORING: Review article
C2 - 22876531
VL - 25
SP - 239
EP - 244
JO - J PEDIATR ENDOCR MET
JF - J PEDIATR ENDOCR MET
SN - 0334-018X
IS - 3-4
ER -