Catterall classification of Perthes disease

Last revised by Dr Rohit Sharma on 07 Feb 2020

The Catterall classification of Perthes disease is based on radiographic appearances of the epiphysis and metaphysis visible in osteonecrosis of the femoral head:

  • stage I
    • bone absorption changes visible in the anterior aspect of the epiphysis of femoral head
    • changes are visible best in frog leg lateral view
    • no sclerosis is seen
  • stage II
    • further bone resorption with slight femoral head collapse in the anterior aspect of femoral head
    • sclerosis
  • stage III
    • almost entire femoral head involved in collapse with characteristic head within head appearance
    • sclerosis
  • stage IV
    • complete collapse of femoral head with flattening and formation of dense sclerosis; additional metaphyseal changes may be visible
    • sclerosis
    • posterior remodeling

See also

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Cases and figures

  • Figure 1: Catterall classification
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