Slipped Capital Femoral Epiphysis Unmasking Pituitary Gigantism in a 14-Year-Old Boy: Case Report of a Simple Fall That Revealed a Giant Secret
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Abstract
Background: Pituitary gigantism is a rare endocrine disorder that can present with various orthopaedic complications. Slipped capital femoral epiphysis (SCFE) is a serious complication occurring in 30-60% of patients with growth hormone excess. Case Presentation: We report a 14-year-old boy who presented with left hip pain and difficulty weight-bearing following a trivial fall. Clinical examination revealed a tall boy with acromegalic features including large hands, feet (shoe size 48), and prognathism. Pelvic X-ray confirmed left SCFE. Further evaluation revealed rapid growth over three years, visual disturbances, and headaches. Hormonal studies showed elevated IGF-1 (843 ng/ml) and prolactin (835.08 μg/L). Brain MRI demonstrated a suprasellar mass with parasellar extension. The patient underwent closed reduction and pinning of the affected hip with prophylactic pinning of the contralateral hip, followed by endoscopic transsphenoidal resection of the pituitary adenoma. Conclusion: This case highlights the importance of screening adolescents with SCFE for underlying endocrinopathies. Early recognition and multidisciplinary management involving orthopaedics, endocrinology, neurosurgery, and ophthalmology are essential for optimal outcomes in pituitary gigantism.
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Copyright (c) 2025 Michael O. Okunola, Jemiludeen O. Morhason-Bello, Mosimabale J. Balogun, Richard A. Omoyeni, Oluwafisayo F. Awi, Saheed. O. Olaoye, Olubunmi O. Ajao, Jesse Tanko
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Michael O. Okunola, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Jemiludeen O. Morhason-Bello, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Mosimabale J. Balogun, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Richard A. Omoyeni, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Oluwafisayo F. Awi, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Saheed. O. Olaoye, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Olubunmi O. Ajao, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Jesse Tanko, Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria.
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