Legg-Perthes disease in children under 6 years old.
A roentgenographic review was made of 109 patients with unilateral Legg-Perthes disease, all of whom had experienced onset of symptoms prior to their sixth birthday. Roentgenograms taken at the time of healing and at final follow-up were grouped according to Catterall classification and modified Mose rating. The parameters measured were epiphyseal index, center-edge angle, extrusion index, epiphyseal quotient, and center-edge quotient. Average age at final follow-up was 12 years. A change in Mose rating between assessments at healing and final follow-up occurred in 16% of patients, with most of them showing improvement, supporting the concept that femoral heads in young children have the capacity to remodel. However, 24% of patients with Catterall III and IV disease had a poor result at final follow-up. Despite early onset of Legg-Perthes disease, patients with involvement of greater than half the femoral head are at risk for poor roentgenographic result.
Schoenecker
P L
PL
Division of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri.
Stone
J W
JW
Capelli
A M
AM
D000367:Age Factors; D002675:Child, Preschool; D004838:Epiphyses / Q000000981:diagnostic imaging; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000145:classification / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors