Perthes disease

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Pain in both hips

Patient Data

Age: 17 years
Gender: Male
mri

Deformity with fragmentation, subchondral collapse and flattening of bilateral femoral head epiphyses is seen. Incongruency of both hip joints is seen with lateral subluxation of femoral heads. Widening of both femoral necks is seen. Subtle subchondral sclerosis of anterior aspects of acetabulum is also seen.
Bilateral mild joint effusion is seen.
 

Case Discussion

Overall above findings suggest likelihood of late stage of Perthes disease bilaterally. Legg-Calvé-Perthes disease refers to idiopathic avascular necrosis of the femoral epiphysis which mainly affects boys with peak incidence at 5-6 years of age. Late stage of the disease is treated with hip replacement.

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