DOI: 10.36347/sjams.2017.v05i03.054

Pages: 995-1005

Legg-Calvé-Perthes disease is a common cause of hip pain in preadolescent children that may be initially clinically and radiographically difficult to diagnose and stage. Till recently, diagnosis and treatment decisions were based on X-rays. At present, MR Imaging plays a crucial role in the management of Perthes disease. The purpose of this article is to analyze the femoral head pathology in Perthes Disease at tissue level by different MR sequences. A total of 20 MRI of hips with Perthes disease were analyzed in 18 children aged 3 to 13 yrs. Nine patients had unilateral Perthes disease with normal contralateral hip, 2 children had bilateral Perthes disease and the remaining 7 patients had unilateral Perthes disease with the other hip showing varied changes in epiphysis and synovium. Five hips (25%) showed air pockets in the epiphyses, fluid intense areas were appreciated in 50% of the affected epiphysis and fat was the most frequent component (70%) noted. Migration index of LCPD hips had a wide range (14.52 - 53.15). Statistically significant correlation was documented for MI and Catterall group (P < 0.01). Fifteen hips (75%) showed physeal bars and sixteen hips (80%) had metaphyseal cysts. Metaphyseal cysts were heterogenous with fat, cartilage, fluid and air as contents. Air was detected in metaphyseal cysts in three hips (18.75%). All the 20 hips showed synovial effusion. Seventeen hips showed synovial enhancement (85%), 6 hips showed synovial thickening and 1 patient had marked, irregular synovial thickening.