Perthes disease

Case contributed by Dr Abeer Ahmed Alhelali

Presentation

Intermittent limping especially after exertion.

Patient Data

Age: 7 years
Gender: Male
X-ray

Small capital femoral epiphysis noted in the right hip with sclerotic changes and minimal widening of the joint space.

X-ray

Few months later

The patient was advised to have bed rest and not to overuse his limb, however, repeated x-ray showed fragmentation of right femoral capital epiphysis which has progressed from the earlier study with preserved acetabulum.

Case Discussion

Legg-Calve-Perthes Disease is idiopathic osteonecrosis of the capital femoral epiphysis, usually unilateral and occurs in young people as in our case. Seen mainly in males aged 4-8 years.

It can be staged with the Catterall classification:

  • stage I: clinical and histological diagnosis; no radiographic findings
  • stage II: sclerosis of epiphysis +/- cystic changes; contour and surface of femoral head are preserved
  • stage III: irregular epiphysis
  • stage IV: irregular epiphysis and acetabulum

Treatment is symptomatic, especially in the early stage of the disease. As the disease progresses, destruction and fragmentation of the femoral head occurs which needs operative management.

Special thanks to Dr Tamer Ibrahim Elholiby.

PlayAdd to Share

Case information

rID: 51002
Case created: 1st Feb 2017
Last edited: 15th Feb 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.