Comparison of MRI with subchondral fracture in the evaluation of extent of epiphyseal necrosis in the early stage of Legg-Calvé-Perthes disease.
We reviewed 20 patients in the early stage of Legg-Calvé-Perthes disease who showed a subchondral fracture line in radiographs. All 20 patients underwent magnetic resonance imaging (MRI) within 2 months after the first symptoms. Follow-up MRI after treatment was performed in 10 patients. The subchondral fracture line in radiographs and serial T1-weighted image was used to measure the extent of the epiphyseal necrosis volumetrically. These extents in the early stage were compared with those in the late stage for determination of prognostic significance. The intensities of coronal MRIs under the subchondral fracture were not homogeneous. The uninvolved epiphysis also showed nonhomogeneous intensities because the posterior column revealed higher intensity compared with the anterior column. The extent of the subchondral fracture line is more accurate in predicting the amount of eventual necrosis than is the extent of necrosis in MRI, which does not have a consistent correlation.
Song
H R
HR
Gyeong-Sang National University Hospital, Chinju, Republic of Korea.
Lee
S H
SH
Na
J B
JB
Cho
S H
SH
Jeong
S T
ST
Ahn
B W
BW
Koo
K H
KH
D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000473:pathology*; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D011859:Radiography; D012680:Sensitivity and Specificity