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Angiography in Perthes' disease
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Angiography reveals reduced blood flow and specific artery issues in Perthes' disease hips. These findings suggest poor blood supply, guiding surgical treatment for ischemic epiphysis.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Orthopedics
Background:
- Perthes' disease is a hip condition affecting children.
- Understanding its vascular basis is crucial for treatment.
- Previous studies have suggested vascular compromise.
Purpose of the Study:
- To investigate the role of angiography in diagnosing Perthes' disease.
- To identify key angiographic findings associated with the condition.
- To correlate angiographic results with treatment indications.
Main Methods:
- Performed angiography in 30 patients with Perthes' disease.
- Included aortography and selective angiography.
- Analyzed major and minor blood vessels in the hip.
Main Results:
- Observed decreased blood flow in affected hips.
- Noted absence or atrophy of the medial circumflex artery.
- Identified vessel distention in subluxations and obturator artery absence.
- Found no sex-based differences in hip circulation.
Conclusions:
- Angiography highlights deficient blood supply and ischemic epiphysis in Perthes' disease.
- Specific findings like medial circumflex artery issues are significant.
- Surgical intervention is recommended for progressing cases with vessel distention and necrosis.
Abstract:
Angiography may play an important role in the understanding of the cause and treatment of Perthes' disease. Angiograms were performed in 30 patients, including 26 aortographies and six selective angiographies. The major angiographic alterations were: general decrease of blood flow in the affected hip, lack of a patent medial circumflex artery, an atrophic medial circumflex artery or obstruction of its branches, distended vessels in subluxations of the hip joint, and almost complete absence of the obturator artery. These anatomic differences between normal and pathologic hips suggest a deficient blood supply in the affected side and an ischemic epiphysis. Surgical treatment is indicated in cases in which distention of the circumflex vessels is noted and the condition progresses to massive necrosis. There were no differences in circulation of the hip between men and women afflicted with Perthes' disease.