Please enable JavaScript.

Coggle requires JavaScript to display documents.

Legg-Calvé-Perthes Disease., Quick facts: Perthes’ disease Commonest…

- - - - Environmental factors: Majority of children belong to the poorer class.
        
        Sex: 80 % affected are males (4:1).
        
        Trauma to the hip joints
  - - - Idiopathic capital femoral epiphyseal ischemia
        (initial infarction)
        
        Temporary cessation of epiphyseal growth
        
        Epiphyseal revascularization occurs from periphery
        
        Resumption of growth and ossification
        
        No subchondral
        fracture
        
        Potential form
        
        1 more item...
        
        subchondral fracture
        
        true form
        
        1 more item...
      - changes in
        
        Capital femoral epiphysis
        
        initial ischemia
        .
        
        is followed by revascularization
        .
        
        & pathological subchondral fracture occurs due to trauma or vigorous active movement
        .
        
        This results in a second mechanical ischemic episode, which heralds the onset of true form of Perthes.
        .
        
        Again, slow revascularization called creeping substitution takes place and the head is moulded due to the forces acting on it (biologic plasticity)
        
        Epiphyseal growth plate changes:
        
        The two ischemic episodes mentioned above also take place here.
        
        Metaphyseal changes:
        
        4 characteristic changes are seen in the metaphyseal area:
        
        presence of adipose tissue,
        
        osteolytic lesions,
        
        disorganized ossification,
        
        & extrusion of growth plate
        
        Ultimate result:
        
        Following the epiphyseal growth plate
        and metaphyseal changes, the following results are seen
        
        1 more item...
        
        Clinical Features
        
        It is usually common in boys between 4 and 8 years (mean age 7 years) but can also occur less than 2 years and more than 12 years
        
        If the child is older than 12 years, it is not true Perthes’ disease but rather
        adolescent avascular necrosis.
        
        Symptoms
        
        Painless limp (classical presentation)
        .
        
        Mild pain in the hip or anterior thigh or knee
        .
        
        History of trauma may be present or absent
        .
        
        Onset of pain may be acute or insidious.
        
        Signs
        
        Antalgic gait
        .
        
        Muscle spasm (detected by roll test)
        .
        
        Proximal thigh atrophy (by 2-3 cm)
        .
        
        Limitation of abduction and internal rotation
        .
        
        Short stature.
        
        Clinical Tests
        
        Internal rotation test
        
        2 more items...
        
        Radiographic Characteristics
        
        2 more items...