Pain in the left hip that is exacerbated by leg movement.
Pelvis / hip x-rays
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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.
4 case question available
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.