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- What are the endocrine causes of slipped capital femoral epiphysis?
Primary hypothyroidism, growth hormone defi ciency, rhGH therapy, Cushing’s
syndrome, obesity, and primary hyperparathyroidism are the important endo-
crine causes of slipped capital femoral epiphysis. It is commonly bilateral and
occurs due to disproportionate growth of epiphyseal growth plate as compared
to head of the femur.- What are the disorders associated with increased prevalence of hypothyroidism?
Disorders associated with increased prevalence of hypothyroidism include
Turner syndrome, Down syndrome, celiac disease, type 1 diabetes, William
syndrome, and Klinefelter’s syndrome.- A 4 - year - old girl presented with goiter. On evaluation , thyroid function test
showed T 4 3.5 μ g / dl and TSH 29 μ IU / ml. How to evaluate further?
The index child has primary hypothyroidism. The common causes of primary
hypothyroidism in children include Hashimoto’s disease and delayed- onset
dyshormonogenesis. Therefore, further evaluation includes estimation of anti-
thyroid peroxidase antibody and perchlorate discharge test. In addition, X-rays
for bone age estimation should also be performed. In children without goiter,
99m Tc pertechnetate scan should be performed to assess the presence/absence of
ectopic thyroid tissue.
Fig. 3.15 Plain
radiograph of pelvis
depicting stippled femoral
epiphysis ( red arrows ) in a
patient with juvenile
primary hypothyroidism
3 Thyroid Disorders in Children