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Legg-Calve-Perthes Disease: Imaging Evaluation and Management
George W. Gross1, Glenn A. Articolo, J. Richard Bowen
1Department of Medical Imaging, A. I. duPont Hospital for Children, Wilmington, Delaware.
Seminars in Musculoskeletal Radiology
|June 5, 2001
Summary
Legg-Calve-Perthes disease is childhood avascular necrosis of the hip. Treatment focuses on containing the femoral head to preserve joint function and range of motion.
Area of Science:
- Pediatric Orthopedics
- Pediatric Bone Diseases
- Pediatric Hip Disorders
Background:
- Legg-Calve-Perthes disease involves avascular necrosis of the proximal femoral epiphysis and growth plate.
- It typically affects children aged 4 to 8 years.
- The primary cause is likely vascular deficiency to the femoral epiphysis and growth plate.
Purpose of the Study:
- To outline the pathological stages of Legg-Calve-Perthes disease.
- To correlate radiologic findings with pathological stages.
- To discuss treatment principles and surgical options.
Main Methods:
- Review of pathological stages: necrosis, resorption, reossification, and remodeling.
- Correlation of radiographic findings with disease progression.
- Analysis of treatment strategies focusing on femoral head containment.
Main Results:
- Pathologic stages of Legg-Calve-Perthes disease are well-defined.
- Radiologic findings mirror the distinct pathological stages.
- Femoral head containment within the acetabulum is crucial for successful treatment outcomes.
Conclusions:
- Effective management of Legg-Calve-Perthes disease requires understanding its pathological progression.
- Treatment emphasizes maintaining femoral head containment and preserving range of motion.
- Surgical interventions like femoral osteotomy and shelf arthroplasty are considered.