Page 91 - Slipped Capital Femoral Epiphysis Pathogenetic and Clinical aspects

4 had an acute on chronic slip, 1 had an acute slip and 3 had a pre-slip. There was no record for 2 of the hips. The slip was classified as stable in 15 hips, unstable in 1 hip and in 4 hips there was no record of weight bearing. The mean BMI in patients with SCFE was 23.4 (18.7-31.5) n=13.
Five boys and 4 girls served as controls. In one boy and one girl, a biopsy was taken of the proximal tibia and distal femur in the same procedure. The mean age in boys was 8 (1-14) and 9.8 (4-12) in girls. The BMI in the controls was 16.1 (9.9-19.2) n=8. (See table 2)
Table 2
Patients clinical features NA=not applicable
Total (biopsies)
Total Pt
M v F
Age <11 v ≥11 (biopsies)
BMI <25 v ≥25 (biopsies)
Pre v acute v ac-on-chronic v chronic v unknown Weightbare yes v no v unknown
Southwick angle slip mild moderate severe*
*Mild slip <30, moderate slip 30-50, severe slip >60 degrees
Histomorphology
20
18 12 v 6 2 v 18 9 v 4 3 v 1 v 4 v 10 v 2 15 v 1 v 4 10 v 4 v 6
11 9 5 v4
4 v7 5 10 v0
NA NA NA
Slipped Capital Femoral Epiphysis
Case
control
Biopsies differed in their physis integrity, as some biopsies showed only one site adjacent to the physis (the metaphysis). In some biopsies, physis had disappeared in the last sections due to limited material (see table 3). The main feature of the slipped physis, as seen in the biopsies taken, was a disturbed architecture of hypertrophic chondrocytes. Cells were distributed fragmentarily and haphazardly and were sometimes difficult to characterize. In general, however, they maintained their characteristic hypertrophic appearance (See figure 1A and B).
All biopsies demonstrated S100 expression in the cytoplasm of the hypertrophic chondrocytes and in all biopsies, expression was brisk. No significant differences, pertaining to S100 expression, were found between SCFE patients and the controls, nor were there significant differences between age, weight, BMI or gender (See figure 2A en 1B).
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