Monday, May 30, 2011

Legg-Clave-Perthes disease - Diagnosis

Laboratory studies include complete blood count and evaluation ofincreased erythrocyte sedimentation rate.

Imaging Studies:
Plain radiograph of the hip is extremely useful in diagnosis. They look and radiolucenta subchondral sclerosis in the femoral headaffected. It is smaller in size compared to the healthy. Note thefragmentation and flattening of the femoral head. Affected thighlooks frog legs. The apparent joint space widening,demneralizarea metaphyses in the acute phase and are maintained 1-2 weeks. decreased bone density inside and outside the joint is noted after several weeks.
With disease progression of joint space widens acetabulum andfemoral head, are dense necrotic centers of ossification, femoral head collapse cause coxa plana.
Note the five radiographic stages:
femoral epiphysis, growth cessation, lower femoral epiphysis
-subchondral fracture, femoral head epiphysis linear radiolucenta
bone-resorption
new bone-reosificarea
-stage healing.

The differential diagnosis is made ​​with the following conditions:sickle cell anemia, rheumatoid arthritis, pelvic fractures,hypothyroidism, limp leg pediatric tuberculosis, septic hip, toxicsynovitis, lymphoma, spondiloepifizeala dysplasia, dysplasia ofmetaphyses.

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