• To review the different stages of Legg-Calvé-Perthes disease (LCPD),
using conventional radiography and magnetic resonance imaging (MRI). • To highlight the role of MRI in LCPD evaluation.
Introduction LCPD is an idiopathic avascular necrosis of the femoral head and an important cause of pediatric hip pain.
It occurs between 2-14 years old,
with peak incidence around 6 years old and boys are more affected than girls (5:1),
more often white children. Estimated incidence is 5-15/100.000 children.
It may be bilateral in 15% of patients,
usually asynchronous. The cause of disease remains unclear.
Some predisposing factors were suggested but are still controversial (positive family...
Findings and procedure details
Imaging findings depend on the different stages of the disease. Stage I: initial,
avascular necrosis Radiographs may be normal. Growth failure of ossification nucleus – smaller and sclerotic. Subchondral fracture - crescent sign or Caffey's sign ( Fig. 4 )- curvilinear subchondral radiolucent line at the anterosuperior aspect of the femoral head.
It shows T2-WI signal hyperintensity and T1-WI signal hypointensity. MRI can show signs of impaired femoral head perfusion - partial or complete...
Conventional radiography is the main imaging method for diagnosis and follow up. MRI is the most sensitive method to diagnose LCPD and shows changes prior to radiographs,
allowing earlier diagnosis and treatment. MRI can exclude other causes of hip pain and depict complications.
Drª Ana Luísa Proença, Department of Radiology,
Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisboa,
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et al. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease .
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Indian Journal of Orthopaedics,
Issue 1 Legg Calve Perthes Disease.
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