Legg-Calve-Perthe's Disease

 

• Peak incidence is five years with a range of 2-14 years

 

• Bilateral in 10%

 

• Males greater than females

 

• Bilateral involvement in females is very rare

 

• The first sign is subarticular translucency seen best on frog lateral

 

• Then epiphysis becomes flattened, fragment and dense
   

 

Frontal radiograph of left hip in a 3 year-old shows flattening,
sclerosis and cystic lucencies with preservation of the hip joint space

 

• With revascularization there is gradual reformation of femoral head. 

 

• Since there is less bone to reform, prognosis is better for those under five years of age than in older children. 

 

• Arthrography will, except in severe cases, be normal because cartilage derives its nutrition from synovial fluid. 

 

• First sign may be joint effusion as shown by lateral displacement of femoral head

 

• Poor prognosis if there is severe and lateral displacement of metaphysis, by involvement of lateral aspect of head, and by flattening of cartilage seen on arthrography