In this review about perfusion magnetic resonance imaging (pMRI), we consider it to give detailed insight into the distribution of the infarction in the femoral head in the early phase of Perthes disease. The degree of head involvement is closely related to the long-term prognosis, and as early surgical treatment of children with severe head involvement may be beneficial, pMRI is suggested as an examination in older children with early stages of Perthes disease. The use of gadolinium as contrast medium in otherwise healthy children seems safe, but long-term effects are unknown.

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