Cartilaginous abnormalities and growth disturbances in Legg-Calvé-Perthes disease: evaluation with MR imaging

Radiology. 1995 Dec;197(3):767-73. doi: 10.1148/radiology.197.3.7480754.

Abstract

Purpose: To evaluate the magnetic resonance (MR) imaging appearance of cartilaginous abnormalities in Legg-Calvé-Perthes (LCP) disease and their association with growth arrest.

Materials and methods: Twenty-seven MR images and radiographs of 25 hips in 23 patients were reviewed for epiphyseal, physeal, and metaphyseal abnormalities. Follow-up radiographs (mean time, 20.5 months) were evaluated for growth arrest.

Results: Epiphyseal abnormality seen in 74% of cases was not related to growth disturbances. Transphyseal bone bridging on MR images, the strongest predictor of abnormal growth (P < .01), was found in 63% of femurs. MR imaging helped detect physeal abnormalities with greater sensitivity (94%), specificity (89%), and positive predictive value (94%) than radiography. Metaphyseal extension of physeal cartilage seen in 81% of cases was associated with growth abnormality (P < .01), particularly when detected at radiography.

Conclusion: Cartilaginous physeal and metaphyseal abnormalities in LCP disease are common and frequently result in growth arrest.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Cartilage Diseases / diagnosis*
  • Cartilage Diseases / diagnostic imaging
  • Cartilage Diseases / physiopathology
  • Child
  • Child, Preschool
  • Epiphyses / diagnostic imaging
  • Epiphyses / growth & development
  • Epiphyses / pathology
  • Female
  • Femur / diagnostic imaging
  • Femur / growth & development
  • Femur / pathology
  • Femur Head / diagnostic imaging
  • Femur Head / growth & development
  • Femur Head / pathology
  • Femur Head Necrosis / diagnosis
  • Femur Head Necrosis / diagnostic imaging
  • Femur Head Necrosis / physiopathology
  • Follow-Up Studies
  • Forecasting
  • Growth Disorders / diagnosis*
  • Growth Disorders / diagnostic imaging
  • Growth Disorders / physiopathology
  • Hip Joint / diagnostic imaging
  • Hip Joint / growth & development
  • Hip Joint / pathology
  • Humans
  • Legg-Calve-Perthes Disease / diagnosis*
  • Legg-Calve-Perthes Disease / diagnostic imaging
  • Legg-Calve-Perthes Disease / physiopathology
  • Magnetic Resonance Imaging*
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Radiography
  • Sensitivity and Specificity