IS Case 308: Legg-Calve-Perthes

Benita Tamrazi, MD


Imaging Sciences URMC 2009
Publication Date: 2009-09-14

History

Patient is a 9-year-old male with hip pain.

Findings

Shielded AP view of the pelvis shows loss of height of the right capital femoral epiphysis with some contour abnormality and patchy sclerosis without fragmentation. There is subphyseal metaphyseal lucency of the proximal right femur consistent with hyperemia. There is widening of the right hip joint space with lateral uncovering a right capital femoral epiphysis. Left hip appears normal.

Diagnosis

Legg-Calve-Perthes

Discussion

Legg-Calve-Perthes disease is a childhood hip disorder that results in infarction of the epiphysis of the femoral head. The pathophysiology involves osteonecrosis and flattening with collapse of the femoral head. There is insufficient blood supply to the femoral head. Patients are typically 2-12 years old. Children often present with a limp and complain of groin, thigh, or knee pain. Plain radiographs may be normal in early symptomatic disease, but overall have a sensitivity of 97% and specificity of 78% in detecting the disease. A frogleg lateral view of the pelvis including bilateral hips is often recommended for complete evaluation of the disease.

References

  1. Rosenfeld SB, Herring JA, Chao JC. Legg-calve-perthes disease: a review of cases with onset before six years of age. J Bone Joint Surg Am. 2007 Dec; 89 (12):2712-22. PMID: 18056504

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