Conclusions

For orthopedic surgeons and emergency physicians, this case highlights that unoccluded growth plates in adult patients represent a rare but important radiographic red flag that requires prompt endocrinological investigation and careful differential diagnosis rather than a pathognomonic finding on its own. Early recognition and appropriate hormonal replacement therapy are essential for addressing endocrine deficiency and supporting skeletal maturation. Long-term follow-up in this patient will be necessary to determine the effectiveness of testosterone therapy and to provide further insights into skeletal outcomes when treatment is initiated in adulthood.