RADIOGRAPHIC STUDY OF THE MEDIAL JOINT SPACE OF THE HIP IN LEGG-CALVÉ-PERTHES DISEASE.

Acta Ortop Bras

Universidade Federal de São Paulo, Paulista School of Medicine, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.

Published: December 2022

AI Article Synopsis

  • The study aims to assess the medial joint space in hips affected by Legg-Calvé-Perthes disease (LCPD) compared to healthy hips, using 127 X-rays from patients with unilateral LCPD.
  • Results indicated that while there were no significant differences in medial space coefficient (MSC) between affected and normal hips, the medial joint distance was greater in affected hips, especially during the necrosis and fragmentation phase.
  • The findings suggest that relying solely on X-ray imaging for diagnosing LCPD is inadequate, as it can lead to delayed treatment; additional imaging tests, like MRI, are recommended for accurate diagnosis.

Article Abstract

Objective: To evaluate medial joint space in affected and normal contralateral hips in patients with Legg-Calvé-Perthes disease (LCPD).

Methods: To compare joint space, femoral head extrusion (FHE), medial space coefficient (MSC) of the hip, and femoral head width (FHW) in affected and normal hips, using 127 radiographs of patients with unilateral LCPD and considering age groups under and over six years old as well as their disease stage.

Results: No statistically significant differences were observed regarding MSC between normal and affected hips regardless of disease staging. However, medial joint distance was significantly greater in affected hips than in normal hips. In the necrosis and fragmentation phase, distance from medial space in affected hips was significantly greater than in contralateral normal hips. Comparing only affected hips, MSC and FHW showed statistically significant differences and the group > 6 yo presented higher values. Among normal hips, the group < 6 yo presented a statistically significant difference considering the MSC and FHW.

Conclusions: No statistically significant difference was found between the medial joint space of affected and normal hips, except for early stages of the disease (necrosis and fragmentation). The isolated use of radiographic study is insufficient in LCPD and the lack of complementation with other exams, such as magnetic resonance, can delay diagnosis of and onset of treatment for the disease.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757733PMC
http://dx.doi.org/10.1590/1413-785220223006e256112DOI Listing

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