The Imaging of Legg-Calve-Perthes Disease

Dmitry A. Lezhnev, Nataliya A. Sholokhova, Alla M. Ganieva, Alexander Yu. Vasilyev, Elena A. Egorova, Elena B. Olkhova, Viktor P. Truten, Margarita V. Smyslenova, Viktoriya V. Petrovskaya, Margarita O. Dutova

 
International Journal of Biomedicine. 2019;9(1):9-12.
DOI: 10.21103/Article9(1)_RA1
Originally published March 15, 2019

Abstract: 

Diagnosis of hip joint pathology remains a serious problem in childhood and adolescence. A wide range of pathologies—including dysplastic, dystrophic, inflammatory, oncological and post-traumatic diseases of the musculoskeletal system—leads to the advancement of imaging methods and techniques. Legg-Calve-Perthes disease (LCPD) is a common cause of hip pain in children that may be initially clinically and radiographically difficult to diagnose Radiography of the pelvis in two views (anteroposterior and Lauenstein) is the main method of diagnosing aseptic necrosis. Destructive changes of the femoral head and neck of the femur are clearly determined. However, the presence of X-ray negative patterns at the first stage of the disease and the impossibility of visualizing all the anatomical structures induce us to improve the diagnostic algorithm of this difficult pathological process.

Keywords: 
Legg-Calve-Perthes disease • osteochondropathy hip pain • radiography • MRI
References: 
  1. Stalmakhovich VN, Dudenkov VV, Dyukov AP, Dmitrienko AP. [Surgical treatment of the acquired deformation of the thorax at children]. Siberian Medical Journal (Irkutsk). 2010;97(6):232-233. [Article in Russian].
  2. Kamosko MM, Poznovich MS. [Radiological diagnosis of hip joint abnormalities in children]. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):32-41. [Article in Russian].
  3. Mirskaya NB, Kolomenskaya AN, Sinyakina AD. [Medico-social significance of disorders and diseases of the musculoskeletal system of children and adolescents (literature review)]. Gig Sanit. 2015;94(1):97-104. [Article in Russian].
  4. Krutikova NYu, Vinogradova AG, 2015. Legg-Calve-Perthes disease. [Current pediatrics]. 2015;14(5):548-552. [Article in Russian].
  5. Catterall A, Chir M. Thoughts on the etiology of Perthes' disease. The Iowa Orthopaedic Journal. 1984;4:34–36.
  6. Dementsov AB. [Perthes disease: etiology, clinical presentation, pathogenesis, treatment methods]. Meditsinskie novosti. 2013;7(18). [Article in Russian].
  7. Tikhonenko TI, Vybornov DYu, Gurevich AI, Lozovaya YuI. [Ultrasound examination of the hip joints in assessing the effectiveness of treatment of children with Legg-Calve-Perthes disease and coxarthritis]. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):68-75. [Article in Russian].
  8. Leroux J, Abu Amara S, Lechevallier J. Legg-Calvé-Perthes disease. Orthop Traumatol Surg Res. 2018 Feb;104(1S):S107-S112. doi: 10.1016/j.otsr.2017.04.012.
  9. Laine JC, Martin BD, Novotny SA, Kelly DM. Role of Advanced Imaging in the Diagnosis and Management of Active Legg-Calvé-Perthes Disease. .J Am Acad Orthop Surg. 2018 Aug 1;26(15):526-536. doi: 10.5435/JAAOS-D-16-00856.
  10. Ficat RP, Arlet J. Necrosis of the femoral head. In: Hungerford DS, eds. Ischemia and necrosis of bone. Baltimore, Md: Williams & Wilkins; 1980:171-182.
  11. Mazloumi SM, Ebrahimzadeh MH, Kachooei AR. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease. Arch Bone Jt Surg. 2014;2(2):86-92.
  12. Axhausen G. Der anatomische Krankheitsverlauf bei der Kohlerschen Krankheit der Metatarrsalkopfchen und der Perthes’schen Krankheit des Huftkopfes. Arch Klin Chir. 1923; 124:511-542.
  13. Ibrahim T1, Little DG. The Pathogenesis and Treatment of Legg-Calvé-Perthes Disease. JBJS Rev. 2016;4(7). pii: 01874474-201607000-00003. doi: 10.2106/JBJS.RVW.15.00063.
  14. Bryukhanov A, Vasiliev AYu. Magnetic resonance imaging in osteology. M., Meditsina; 2006. [In Russian].
  15. Menshchikova TI, Maltseva LV. [Features of ultrasound diagnostics of the initial manifestations of Legg-Calve-Perthes disease in children]. Mezhdunarodnyi zhurnal prikladnyh i fundamentalnyh issledovanii. 2015;(2-1):54-58. [Article in Russian].
  16. Golovkin SI, Utkin VA, Kravets YM, Shabaldin NA. [X-ray and ultrasonographical criteria of prediction of unfavorable course of the synovitus of the hip joint in children during the initial examination]. Mother and Baby in Kuzbass. 2016;(2):20-28. [Article in Russian].
  17. Kozhevnikov VV, Osipiv AA, Grigiricheva LG, Voronchihin EV, Timoshenskaya NV, Lobanov MN, et al. [Ultrasound dopplerography of the hip joint and correction of the disorders revealed in children with dystrophic changes in femoral head]. The Ilizarov Journal of Clinical and Experimental Orthopaedics (Genij Ortopedii). 2015;(1):47-52. [Article in Russian].
  18. Vasilyev AYu, Karpov SS. [Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease)]. Almanac of Clinical Medicine.2017;45(1):14–22. [Article in Russian].
  19. Bogolepova NN, Rostovtsev MV. [Use of tomosynthesis in children's medical institution]. Pediatricheskii vestnik Yuzhnogo Urala. 2013;2:49-56. [Article in Russian].

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Received January 19, 2019.
Accepted January 29, 2019.
©2019 International Medical Research and Development Corporation.