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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.
Insights
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.
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.
Abstract:
In 40 children with unilateral Perthes' disease, we measured the physeal slope, the angle between the physeal plane and the axis of the femoral shaft, from radiographs taken early in the disease. Thirty-seven of the 40 hips were classified as Catterall grades III and IV. Heat-at-risk signs were present in 23. We found no statistically significant difference in the physeal slope between the involved and normal hips (p = 0.20), those with or without head-at-risk signs (p = 0.96), those with or without lateral epiphyseal subluxation (p = 0.82), and different Catterall (p = 0.56) or lateral pillar (p = 0.67) gradings.