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Physeal slope in Perthes disease

R T Loder1, F A Farley, R N Hensinger

  • 1Section of Orthopaedic Surgery, University of Michigan Hospitals, Ann Arbor 48109-0328, USA.

The Journal of Bone and Joint Surgery. British Volume
|September 1, 1995
PubMed
Summary

The physeal slope in children with Perthes disease did not significantly differ between affected and unaffected hips. This angle also showed no correlation with head-at-risk signs or disease severity grading.

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Area of Science:

  • Pediatric Orthopedics
  • Pediatric Radiology
  • Pediatric Rheumatology

Background:

  • Perthes disease affects the hip joint in children, potentially leading to long-term complications.
  • Early radiographic assessment is crucial for predicting outcomes in Perthes disease.
  • The physeal slope is a radiographic measurement that may offer prognostic information.

Purpose of the Study:

  • To investigate the relationship between the physeal slope and clinical/radiographic parameters in early Perthes disease.
  • To determine if the physeal slope can predict 'head-at-risk' signs or disease severity.

Main Methods:

  • Radiographs of 40 children with unilateral Perthes disease were analyzed.
  • The physeal slope was measured as the angle between the physeal plane and the femoral shaft axis.
  • Hips were classified using Catterall and lateral pillar grading systems.

Main Results:

  • No statistically significant difference was found in the physeal slope between involved and normal hips (p = 0.20).
  • The physeal slope did not correlate with the presence of head-at-risk signs (p = 0.96).
  • No significant association was observed between physeal slope and Catterall or lateral pillar gradings (p = 0.56, p = 0.67).

Conclusions:

  • The physeal slope is not a significant predictor of disease severity or 'head-at-risk' signs in early Perthes disease.
  • This finding suggests that other radiographic parameters may be more important for prognostication in this condition.
  • Further research may explore the utility of the physeal slope in different stages or subtypes of Perthes disease.

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