This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Imaging

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

As a rule, radiographic changes in Perthe's disease are usually firmly established before symptoms develop although few changes are apparent in very early disease (1):

  • collapse
  • sclerosis - due to reduced resorption and relative osteopenia of the rest of the bone
  • subchondral fractures as the earliest sign of collapse
  • increased joint space
  • femoral head ossification centre is smaller on the affected side and can appear fragmented
  • coxa magna - spherical enlargement of the femoral head probably due to increased vascularity

Waldenström has divided radiological stages which all children with Perthes disease pass through into initial, condensation, fragmentation, repair, and healing stages (1)

MRI can detect avascular areas before there is collapse. MRI is therefore indicated in cases of recurrent irritable hip (3).

Bone scans are useful in early disease when diagnosis can be prompted by demonstration of decreased uptake in the avascular phase and increased uptake in the healing phase.

Reference:

  1. Poul J. Diagnosis of Legg-Calvé-Perthes disease. Ortop Traumatol Rehabil. Oct 30 2004;6(5):604-6
  2. Van Campenhout A, Moens P, Fabry G. Serial bone scintigraphy in Legg-Calvé-Perthes disease: correlation with the Catterall and Herring classification. J Pediatr Orthop B. Jan 2006;15(1):6-10
  3. Sales de Gauzy J, Briot J, Swider P. Coxa magna quantification using MRI in Legg-Calve-Perthes disease.Clin Biomech (Bristol, Avon). Jan 2009;24(1):43-6

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.