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Legg-Calve-Perthes disease

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Pain in the left hip that is exacerbated by leg movement.

Patient Data

Age: 5 years
Gender: Male

Pelvis / hip x-rays

x-ray

The left superior femoral epiphysis is markedly flattened, sclerotic and appear to be undergoing fragmentation. Alignment is unremarkable and the pelvis and acetabulum appear normal. 

The right hip appears normal. 

Case Discussion

This case demonstrates characteristic advanced features of Perthes disease. One hopes to make the diagnosis before plain film changes are this pronounced, as in all likelihood this patient will require a hip replacement as a young adult for secondary osteoarthritis. 

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