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Unexpected MRI findings in clinically suspected Legg-Calvé-Perthes disease

Philip F Lobert1, Jonathan R Dillman, Peter J Strouse

  • 1Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children's Hospital/F3503, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5252, USA.

Pediatric Radiology
|September 25, 2010
PubMed
Abstract

Insights

In children with suspected Legg-Calvé-Perthes (LCP) disease and unclear X-rays, MRI scans often reveal other serious hip pain causes. This imaging is crucial for accurate diagnosis when initial tests are inconclusive.

Area of Science:

  • Pediatric Radiology
  • Orthopedic Imaging
  • Diagnostic Medicine

Background:

  • Contrast-enhanced MRI is used to diagnose Legg-Calvé-Perthes (LCP) disease when radiographs are inconclusive.
  • Children presenting with hip pain and equivocal radiographic findings require further diagnostic evaluation.

Purpose of the Study:

  • To assess the frequency of unexpected, significant causes of hip pain identified by MRI in pediatric patients with suspected LCP disease.
  • To evaluate the diagnostic yield of MRI in cases where initial radiographic assessment is negative or equivocal.

Main Methods:

  • Retrospective review of pediatric contrast-enhanced pelvic and hip MRI reports (January 2000 - February 2009).
  • Inclusion criteria: clinically suspected LCP disease, negative/equivocal radiographs, exclusion of secondary avascular necrosis.
  • Analysis focused on identifying unexpected, clinically important causes of hip pain.

Main Results:

  • Out of 36 pediatric patients, 22 (61%) had normal MRI findings.
  • Four (11%) MRI studies showed findings consistent with LCP disease.
  • Ten (28%) studies revealed unexpected causes: joint effusion/synovitis (n=7), sacral fracture (n=1), apophyseal injury (n=1), and femoral head subluxation (n=1).

Conclusions:

  • MRI frequently identifies unexpected, clinically significant causes of hip pain in children with suspected LCP disease and negative radiographs.
  • This highlights the value of MRI in diagnosing pediatric hip conditions beyond LCP disease.

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