The Journal of Bone and Joint Surgery, Vol 58, Issue 4 459-467, Copyright © 1976 by Journal of Bone and Joint Surgery, Inc
Biochemical abnormalities in patients with slipped capital femoral epiphysis and chondrolysis
A Eisenstein and S Rothschild
A prospective clinical and laboratory study was performed in thirty-four
patients (twenty-two blacks, ten Puerto Ricans, and two whites) who had
slipped capital femoral epiphysis in fifty-two hips. Although the majority
of the laboratory studies were normal, all patients showed significant
elevations of the serum immunoglobulins and C3 component of complement,
with the highest values recorded for IgA. Urinary glycosaminoglycans were
elevated in the few patients studied and increased proportionally with the
duration of the disease. Nine (25 per cent) of the thirty-four patients had
chondrolysis in thirteen hips. The male:female ratio in these nine patients
was 0.8:1, compared with the ratio of 1.4:1 in all thirty-four patients. No
additional biochemical abnormality was found in the patients with
chondrolysis except for a greater elevation of the IgM fraction. These
preliminary and tentative data suggest either that slipping of an epiphysis
produces an antigen which induces an autoimmune state or that slipping is a
localized manifestation of a generalized process resembling some form of
connective-tissue disorder or inflammatory state. There is presumably a
genetically determined sub-group of patients with this disorder who may
have chondrolysis.
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