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Legg-Perthes-Calvé disease: staging by MRI using gadolinium
H Ducou le Pointe1, S Haddad, B Silberman
1Department of Pediatric Radiology, Hôpital d'Enfants Armand-Trousseau, Paris, France.
Pediatric Radiology
|January 1, 1994
Summary
Magnetic resonance imaging (MRI) helps classify Legg-Perthes-Calvé (LPC) disease into five distinct phases. This advanced imaging technique visualizes key areas within the femoral epiphysis, aiding in diagnosis and understanding disease progression.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Diseases
Background:
- Legg-Perthes-Calvé (LPC) disease affects the hip in children.
- Histological evolution is described by Catterall et al.
- Plain radiographs show typical signs but lack detailed epiphyseal information.
Purpose of the Study:
- To explore the utility of MRI in characterizing Legg-Perthes-Calvé (LPC) disease.
- To correlate MRI findings with the known histological progression of LPC.
- To propose an MRI-based classification system for LPC.
Main Methods:
- Twenty-one patients (26 hips) with radiographically diagnosed LPC were evaluated.
- MRI was performed using a 0.5 T MR unit.
- Included nonenhanced T1-weighted, T2*-weighted, and gadolinium-enhanced spin-echo sequences.
Main Results:
- Four distinct areas were identified in the femoral epiphysis: necrosis, regenerative, cartilaginous, and normal fatty bone tissue.
- MRI findings allowed for the differentiation of these epiphyseal components.
- The observed MRI patterns corresponded well with the described histological stages of LPC.
Conclusions:
- MRI provides detailed visualization of the femoral epiphysis in Legg-Perthes-Calvé (LPC) disease.
- An MRI-based classification into five phases (necrosis, regeneration, reconstruction, reossification, sequelae) is proposed.
- This classification may enhance understanding and management of LPC.