Primary hyperparathyroidism presenting as slipped capital femoral epiphysis; a patient assessment and literature review

Abstract

Primary hyperparathyroidism associated with slipped capital femoral epiphysis (SCFE) is rare. We report a case of a 14-year-old girl who presented with limping of gait and was diagnosed to have bilateral SCFE and underwent screw fixation of both hips. She had pain involving multiple joints and tenderness on further evaluation and was found to have biochemical hyperparathyroidism. The patient was initially managed medically, and further investigations revealed a parathyroid lesion in the right superior location. Workup for multiple endocrine neoplasia was negative. She underwent right superior parathyroid adenoma excision, and post-operatively, she was cured of the disease. On follow-up, she is asymptomatic, and her calcium is within normal limits. A literature review showed that SCFE is associated with severe hyperparathyroidism in adolescents.

Keywords: Primary hyperparathyroidism, Slipped capital femoral epiphysis, parathyroid adenoma