Sonography and intracapsular pressure in Perthes' disease. 39 children examined 2-36 months after onset.
39 children with Legg-Calvé-Perthes Disease (LCPD) and with a radiographically unsatisfactory development were examined with sonography regarding synovitis and with intracapsular pressure recording and aspiration performed 15 (2-36) months after the onset of symptoms. The mean anterior sonographic capsular distension was 3.0 (1.0-7.0) mm greater than that of the contralateral, asymptomatic hip. The mean intracapsular pressure was 4.5 (0-11.5) kPa with the hips in extension and neutral rotation, 9.7 (1.3-27.3) kPa with the hips in extension and inward rotation and 0.9 (-0.8-4.7) kPa in 45 degrees of flexion. We conclude that these children have synovitis as diagnosed sonographically. This synovitis is probably symptomatically and prognostically important in LCPD due to increased intracapsular pressure, with pain, a decreased range of motion and, potential joint contracture.
Department of Orthopedics, University Hospital, Lund, Sweden.
G
G
Eckerwall
P
P
Hochbergs
H
H
Wingstrand
N
N
Egund
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D017746:Joint Capsule / Q000503:physiopathology*; D007873:Legg-Calve-Perthes Disease / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D010146:Pain / Q000209:etiology; D011312:Pressure; D011379:Prognosis; D016059:Range of Motion, Articular; D013396:Suction; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D014463:Ultrasonography