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Legg-Calvé-Perthes Disease
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Legg-Calvé-Perthes (LCP) disease
            • Synonyms

              • Legg-Perthes or Perthes disease
              • Juvenile idiopathic osteonecrosis
            • Definitions

              • Idiopathic avascular necrosis of femoral head in children

            IMAGING

            • General Features

              • Radiographic Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        Selected References

                                        1. Divi SN et al: Legg-Calvé-Perthes disease. Pediatr Ann. 45(4):e144-9, 2016
                                        2. Yoo WJ et al: Risk factors for femoral head deformity in the early stage of Legg-Calvé-Perthes disease: MR contrast enhancement and diffusion indexes. Radiology. 279(2):562-70, 2016
                                        3. Hyman JE et al: Interobserver and intraobserver reliability of the modified Waldenström classification system for staging of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 97(8):643-50, 2015
                                        4. Kotoura Y et al: Assessment of lateral subluxation in Legg-Calvé-Perthes disease: a time-sequential study of magnetic resonance imaging and plain radiography. J Pediatr Orthop B. 24(6):493-506, 2015
                                        5. Accadbled F et al: "Femoroacetabular impingement". Legg-Calve-Perthes disease: from childhood to adulthood. Orthop Traumatol Surg Res. 100(6):647-9, 2014
                                        6. Heesakkers N et al: The long-term prognosis of Legg-Calvé-Perthes disease: a historical prospective study with a median follow-up of forty one years. Int Orthop. ePub, 2014
                                        7. Kim HK et al: Perfusion MRI in early stage of Legg-Calvé-Perthes disease to predict lateral pillar involvement: a preliminary study. J Bone Joint Surg Am. 96(14):1152-1160, 2014
                                        8. Mazloumi SM et al: Evolution in diagnosis and treatment of Legg-Calve-Perthes disease. Arch Bone Jt Surg. 2(2):86-92, 2014
                                        9. Park KW et al: Extent of physeal involvement in Legg-Calvé-Perthes disease. Int Orthop. 38(11):2303-8, 2014
                                        10. Shah H: Perthes disease: Evaluation and management. Orthop Clin North Am. 45(1):87-97, 2014
                                        11. Kim HK et al: A comparison of non-contrast and contrast-enhanced MRI in the initial stage of Legg-Calvé-Perthes disease. Pediatr Radiol. 43(9):1166-73, 2013
                                        12. Shah H et al: Quantitative measures for evaluating the radiographic outcome of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 95(4):354-61, 2013
                                        13. Nguyen NA et al: Operative versus nonoperative treatments for Legg-Calvé-Perthes disease: a meta-analysis. J Pediatr Orthop. 32(7):697-705, 2012
                                        14. Ross JR et al: Intraarticular abnormalities in residual Perthes and Perthes-like hip deformities. Clin Orthop Relat Res. 470(11):2968-77, 2012
                                        15. Park MS et al: Reliability and stability of three common classifications for Legg-Calvé-Perthes disease. Clin Orthop Relat Res. 470(9):2376-82, 2012
                                        16. Kuo KN et al: Classification of Legg-Calvé-Perthes disease. J Pediatr Orthop. 31(2 Suppl):S168-73, 2011
                                        17. Lobert PF et al: Unexpected MRI findings in clinically suspected Legg-Calvé-Perthes disease. Pediatr Radiol. 41(3):369-73, 2011
                                        18. Merlini L et al: Diffusion-weighted imaging findings in Perthes disease with dynamic gadolinium-enhanced subtracted (DGS) MR correlation: a preliminary study. Pediatr Radiol. 40(3):318-25, 2010
                                        19. Zilkens C et al: Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in the long-term follow-up after Perthes disease. J Pediatr Orthop. 30(2):147-53, 2010
                                        20. Dillman JR et al: MRI of Legg-Calve-Perthes disease. AJR Am J Roentgenol. 193(5):1394-407, 2009
                                        21. Ha AS et al: Importance of sagittal MR imaging in nontraumatic femoral head osteonecrosis in children. Pediatr Radiol. 38(11):1195-200, 2008
                                        22. Link TM et al: Cartilage imaging: motivation, techniques, current and future significance. Eur Radiol. 17(5):1135-46, 2007
                                        23. Van Tongel A et al: Epiphysiodesis of the greater trochanter in Legg-Calvé-Perthes disease: the importance of timing. Acta Orthop Belg. 72(3):309-13, 2006
                                        24. Rowe SM et al: Dysplasia epiphysealis capitis femoris: meyer dysplasia. J Pediatr Orthop. 25(1):18-21, 2005
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Legg-Calvé-Perthes (LCP) disease
                                                  • Synonyms

                                                    • Legg-Perthes or Perthes disease
                                                    • Juvenile idiopathic osteonecrosis
                                                  • Definitions

                                                    • Idiopathic avascular necrosis of femoral head in children

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              Selected References

                                                                              1. Divi SN et al: Legg-Calvé-Perthes disease. Pediatr Ann. 45(4):e144-9, 2016
                                                                              2. Yoo WJ et al: Risk factors for femoral head deformity in the early stage of Legg-Calvé-Perthes disease: MR contrast enhancement and diffusion indexes. Radiology. 279(2):562-70, 2016
                                                                              3. Hyman JE et al: Interobserver and intraobserver reliability of the modified Waldenström classification system for staging of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 97(8):643-50, 2015
                                                                              4. Kotoura Y et al: Assessment of lateral subluxation in Legg-Calvé-Perthes disease: a time-sequential study of magnetic resonance imaging and plain radiography. J Pediatr Orthop B. 24(6):493-506, 2015
                                                                              5. Accadbled F et al: "Femoroacetabular impingement". Legg-Calve-Perthes disease: from childhood to adulthood. Orthop Traumatol Surg Res. 100(6):647-9, 2014
                                                                              6. Heesakkers N et al: The long-term prognosis of Legg-Calvé-Perthes disease: a historical prospective study with a median follow-up of forty one years. Int Orthop. ePub, 2014
                                                                              7. Kim HK et al: Perfusion MRI in early stage of Legg-Calvé-Perthes disease to predict lateral pillar involvement: a preliminary study. J Bone Joint Surg Am. 96(14):1152-1160, 2014
                                                                              8. Mazloumi SM et al: Evolution in diagnosis and treatment of Legg-Calve-Perthes disease. Arch Bone Jt Surg. 2(2):86-92, 2014
                                                                              9. Park KW et al: Extent of physeal involvement in Legg-Calvé-Perthes disease. Int Orthop. 38(11):2303-8, 2014
                                                                              10. Shah H: Perthes disease: Evaluation and management. Orthop Clin North Am. 45(1):87-97, 2014
                                                                              11. Kim HK et al: A comparison of non-contrast and contrast-enhanced MRI in the initial stage of Legg-Calvé-Perthes disease. Pediatr Radiol. 43(9):1166-73, 2013
                                                                              12. Shah H et al: Quantitative measures for evaluating the radiographic outcome of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 95(4):354-61, 2013
                                                                              13. Nguyen NA et al: Operative versus nonoperative treatments for Legg-Calvé-Perthes disease: a meta-analysis. J Pediatr Orthop. 32(7):697-705, 2012
                                                                              14. Ross JR et al: Intraarticular abnormalities in residual Perthes and Perthes-like hip deformities. Clin Orthop Relat Res. 470(11):2968-77, 2012
                                                                              15. Park MS et al: Reliability and stability of three common classifications for Legg-Calvé-Perthes disease. Clin Orthop Relat Res. 470(9):2376-82, 2012
                                                                              16. Kuo KN et al: Classification of Legg-Calvé-Perthes disease. J Pediatr Orthop. 31(2 Suppl):S168-73, 2011
                                                                              17. Lobert PF et al: Unexpected MRI findings in clinically suspected Legg-Calvé-Perthes disease. Pediatr Radiol. 41(3):369-73, 2011
                                                                              18. Merlini L et al: Diffusion-weighted imaging findings in Perthes disease with dynamic gadolinium-enhanced subtracted (DGS) MR correlation: a preliminary study. Pediatr Radiol. 40(3):318-25, 2010
                                                                              19. Zilkens C et al: Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in the long-term follow-up after Perthes disease. J Pediatr Orthop. 30(2):147-53, 2010
                                                                              20. Dillman JR et al: MRI of Legg-Calve-Perthes disease. AJR Am J Roentgenol. 193(5):1394-407, 2009
                                                                              21. Ha AS et al: Importance of sagittal MR imaging in nontraumatic femoral head osteonecrosis in children. Pediatr Radiol. 38(11):1195-200, 2008
                                                                              22. Link TM et al: Cartilage imaging: motivation, techniques, current and future significance. Eur Radiol. 17(5):1135-46, 2007
                                                                              23. Van Tongel A et al: Epiphysiodesis of the greater trochanter in Legg-Calvé-Perthes disease: the importance of timing. Acta Orthop Belg. 72(3):309-13, 2006
                                                                              24. Rowe SM et al: Dysplasia epiphysealis capitis femoris: meyer dysplasia. J Pediatr Orthop. 25(1):18-21, 2005