Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Seth M. Katzen, DO: No financial relationships or conflicts of interest
Case Description: The patient reported no clear mechanism of injury. Pain increased with ambulation, prolonged sitting or lying on her right side. Pain decreased with standing or lying supine. She trialed short courses of ibuprofen and topical menthol gel without improvement. Past medical history revealed hypopituitarism, delayed puberty and adrenal insufficiency. Past surgical history included ligation of a patent ductus arteriosus and a left nephrectomy in infancy without complications. Exam was notable for antalgic gait and tenderness over right ASIS and AIIS. Passive ROM of the right hip was limited in all directions. Log roll test was negative. FADIR, hip scour, and Stinchfield tests were positive only on the right, but FABER was positive and reproduced groin pain bilaterally. Hip imaging demonstrated delayed closure of the growth plates of the femoral heads and slipped capital femoral epiphysis bilaterally. Brain MRI showed ectopic posterior pituitary gland with a hypoplastic anterior pituitary and non-visualized pituitary stalk.
Setting: Tertiary Care Academic Hospital
Patient: A 21-year-old female with 3 weeks progressive right hip and groin pain Assessment/
Results: The patient was diagnosed with bilateral slipped capital femoral epiphysis secondary to panhypopituitarism, low estrogen, and vitamin D deficiency. Bilateral SCFE was corrected with in situ screw fixation and the patient underwent post-op physical therapy.
Discussion: Traditionally, SCFE is a common cause of hip pain in adolescents usually between 8-15 years of age. Atypical SCFE is seen in cases associated with endocrine disorders, renal failure osteodystrophy or radiation to the pelvis.
Conclusion: It is imperative to maintain a broad differential and consider seemingly unrelated past medical history when creating a differential diagnosis to guide appropriate work-up.
Level of Evidence: Level V
To cite this abstract in AMA style:Katzen SM, Krill MK, Probst DT, Hartman J. An Atypical Cause of Hip Pain in a Young Adult Female: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/an-atypical-cause-of-hip-pain-in-a-young-adult-female-a-case-report/. Accessed September 22, 2023.
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