Slipped capital femoral epiphysis associated with vitamin D deficiency

Abstract

Slipped capital femoral epiphysis (SCFE) is uncommon in India and we routinely look for associated metabolic or endocrine abnormalities. In this study we investigated a possible association between vitamin D deficiency and SCFE. All children presenting with SCFE during the study period had their 25-hydroxyvitamin D levels measured as part of an overall metabolic, renal and endocrine status evaluation, which included measurement of body mass index (BMI). Vitamin D status was compared with age-, gender- and habitat-matched controls with acute trauma or sepsis presenting to our emergency department. A total of 15 children (12 boys and three girls) with a mean age of 13 years (sd 1.81; 10 to 16) presented for treatment for SCFE during a two-year period beginning in January 2010. Renal and thyroid function was within the normal range in all cases. The mean BMI was 24.9 kg/m(2) (17.0 to 33.8), which was significantly higher than that of the controls (p = 0.006). There was a statistically significant difference between the mean values of 25-hydroxyvitamin D in the children with SCFE and the controls (11.78 ng/ml (SD 5.4) versus 27.06 ng/ml (SD 5.53), respectively; p < 0.001). We concluded that, along with high BMI, there is a significant association of vitamin D deficiency and SCFE in India.

Vitamin D Deficiency in Slipped Upper Femoral Epiphysis

“…2,22 However, the reduction of prevalence in males has been noted in other works, 12 although not to the extent where the prevalence in females is higher as observed in our study.…”

“…The potential link between SUFE and nutritional deficiencies with a particular focus on vitamin D deficiency is beginning to be considered, with the case study by Skelley et al 21 and the series of 15 cases by Madhuri et al 22 Indeed, this was evident in our study from the higher percentage of vitamin D-deficient SUFE patients (85.2%) compared with those presenting with a sufficient/ normal vitamin D level (7.4%). Direct comparison with other studies that have reported vitamin D deficiency in UK pediatric patients is difficult because of the varying range of normal vitamin D reference values, with some hospital laboratories using higher values.…”

Early Development of Slipped Capital Femoral Epiphysis in a Patient with Infantile Tibia Vara

“…Bowen et al examined three separate groups of obesity-related conditions in adolescent: tibia vara, SCFE and type 2 diabetes; the authors did not find overlap of these diseases at initial presentation and concluded that no association between them could be shown [11]. On the other hand, Madhuri et al stated that together with high BMI, there is a significant association of vitamin D deficiency and SCFE [12].…”

CORR Insights®: Delayed Slipped Capital Femoral Epiphysis After Treatment of Femoral Neck Fracture in Children

“…This deficiency has been loosely associated with a myriad of musculoskeletal pathology. Two studies [5,9] have reported on patients with SCFE associated with vitamin D deficiency. Skelley et al [9] described SCFE occurring in a patient with known severe vitamin D deficiency.…”

“…Skelley et al [9] described SCFE occurring in a patient with known severe vitamin D deficiency. Mahuri and colleagues [5] measured 25-hydroxyvitamin D levels in SCFE patients and compared them to levels in matched controls. There was a statistically significant lower level of 25-hydroxyvitamin D in the SCFE group.…”