Slipped Capital Femoral Epiphysis as a Presentation of Underlying Metabolic Disorders: Pseudohypoparathyroidism and Juvenile Hypothyroidism

Slipped capital femoral epiphysis (SCFE) is an abnormality of the proximal femoral physis typically occurring in adolescents and most commonly associated with obesity, although its exact etiology is unknown. In addition to obesity, other associations and predisposing factors proposed in the literature include trauma, vascular injury or compromise, and immunologic, genetic, and metabolic conditions. While not common, metabolic conditions are known to predispose to SCFE and it is essential for radiologists to recognize SCFE as a possible initial presentation of an underlying metabolic disorder. Understanding imaging findings and identification of atypical presentations of SCFE by radiologists can assist clinicians in guiding workup and lead to expedited treatment to prevent worsening outcomes associated with developmental delay.