Slipped capital femoral epiphysis in an adult patient with presumed hypogonadotropic hypogonadism: A case report

Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting children and adolescents. Adult patients who present with SCFE are rare and require a full endocrinological workup, as the diagnosis is often associated with endocrinopathies such as panhypopituitarism, hypothyroidism, or hypogonadotropic hypogonadism (HH). A 25-year-old male presenting to the emergency room for one month of worsening left hip pain, who immigrated to the United States from Central America two years prior. Plain radiographs showed a left slipped capital femoral epiphysis (SCFE) in the setting of developmentally delayed bone age with iliac crest consistent with Risser stage II. A detailed endocrinology workup showed low total testosterone, low free testosterone, low FSH, low LH, high adrenocorticotropic hormone. Based on the above examination and laboratory findings, it was suspected that the patient had HH. While our case did allow us to unveil a suspected underlying undiagnosed medical condition, we would argue that it is crucial to screen patients with endocrine disorders using a detailed physical examination of the lower extremities and subsequent pelvic radiographic imaging if needed to rule out SCFE.