Cartilaginous abnormalities and growth disturbances in Legg-Calvé-Perthes disease: evaluation with MR imaging.
OBJECTIVE
To evaluate the magnetic resonance (MR) imaging appearance of cartilaginous abnormalities in Legg-Calvé-Perthes (LCP) disease and their association with growth arrest.


METHODS
Twenty-seven MR images and radiographs of 25 hips in 23 patients were reviewed for epiphyseal, physeal, and metaphyseal abnormalities. Follow-up radiographs (mean time, 20.5 months) were evaluated for growth arrest.


RESULTS
Epiphyseal abnormality seen in 74% of cases was not related to growth disturbances. Transphyseal bone bridging on MR images, the strongest predictor of abnormal growth (P < .01), was found in 63% of femurs. MR imaging helped detect physeal abnormalities with greater sensitivity (94%), specificity (89%), and positive predictive value (94%) than radiography. Metaphyseal extension of physeal cartilage seen in 81% of cases was associated with growth abnormality (P < .01), particularly when detected at radiography.


CONCLUSIONS
Cartilaginous physeal and metaphyseal abnormalities in LCP disease are common and frequently result in growth arrest.
D000293:Adolescent; D002357:Cartilage Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology; D005270:Femur Head / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D005500:Follow-Up Studies; D005544:Forecasting; D006130:Growth Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity