Intra-osseous venous pressure in Legg-Perthes disease

Twenty-three hips in patients with Legg-Perthes disease and twenty-three normal hips were studied. The intra-osseous pressure was measured in the femoral neck in all forty-six hips and was found to be only slightly higher in the hips with Legg-Perthes disease. However, after five milliliters of saline solution was injected intra-osseously, the pressure was significantly higher in the diseased hips than in the controls, and after the pressure had stabilized at five minutes after injection the pressure was even higher in the hips with Legg-Perthes disease. Intra-osseous venography was also performed for all of the hips. All of the control hips had a normal venogram, whereas the venograms in the hips with Legg-Perthes disease were all either mildly or severely abnormal. The rise in the intra-osseous pressure after saline stress in the hips with severe changes on venography was significantly higher than the rise in the hips with mild changes.

Intra-osseous venography and measurement of changes in intra-osseous pressure might aid in the earlier diagnosis of Legg-Perthes disease and prove to be useful monitors of the results of treatment.