The prognostic value and significance of serial bone scintigraphy in Legg-Calvé-Perthes disease.
We reviewed 44 consecutive patients treated for Legg-Calvé-Perthes disease who underwent serial technetium 99m diphosphonate bone scintigraphy. The average follow-up was 4.4 years. The bone-scintigraphy classification characterizes the A pathway by early lateral column formation not seen in the B pathway. Pathway A had 20 hips. The average age at presentation was 6.1 years. At last follow-up, this group had an average Mose classification of 1.2 and Catterall score of 2.4, without any patient having "head-at-risk" signs or requiring operative treatment. Pathway B had 20 hips. The average age at presentation was 5.8 years. At last follow-up, this group had an average Mose classification of 5.2, a Catterall score of 3.5, and 18 patients had head-at-risk signs, with 11 requiring operative treatment. Our bone-scintigraphy classification preceded the radiographic head-at-risk signs by an average of 3 months, allowing earlier treatment and correlated with subsequent femoral head involvement.
Tsao
A K
AK
Children's Memorial Hospital, Chicago, Illinois, USA.
Dias
L S
LS
Conway
J J
JJ
Straka
P
P
D002648:Child; D002675:Child, Preschool; D004164:Diphosphonates; D005271:Femur Head Necrosis / Q000209:etiology; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000145:classification / Q000000981:diagnostic imaging* / Q000628:therapy; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012307:Risk Factors; D017556:Technetium Compounds
D004164:Diphosphonates; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; C029045:technetium Tc 99m diphosphonate