Perthes disease

Case contributed by Dr Jeremy Jones

Presentation

Left sided hip pain for about 4 weeks. No red-flag symptoms.

Patient Data

Age: 5 years
Gender: Male
X-ray

Frog-leg view of both hips. Asymmetry with loss of the normal appearance of the left proximal femora. There is coxa magna (metaphyseal widening) and loss of the femoral epiphysis with sclerosis, lucency and fragmentation.

Case Discussion

Appearances here are of avascular necrosis. In this age-group, when there is no other cause (e.g. steroid treatment, sickle cell disease), Perthes disease (idiopathic AVN) is the diagnosis.

AVN here has been progressing for a while and the acute history do not match the imaging findings.

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Case information

rID: 65845
Published: 26th Jan 2019
Last edited: 27th Jan 2019
Inclusion in quiz mode: Included
Institution: NHS Lothian

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