Radionuclide Evaluation of Legg-Calvé-Perthes Disease

  • James J. Conway


The etiology of Legg-Calvé-Perthes disease (LCP) remains an enigma despite being one of the most frequently studied pediatric orthopedic disorders.3,37,48,95,103 The reasons for the uncertainty surrounding the etiology of LCP are multiple. LCP is a clinically silent disorder during its initial stages, and only with complications such as collapse of the epiphysis or the onset of synovitis do symptoms and signs such as pain and limitation of motion appear. This sequence occurs weeks to months after the onset of the avascular necrosis (AVN) incident. In my experience, the mean duration of symptoms before the appearance of radiographic changes of AVN averages 5 months.20 Importantly, the plain radiographic examination is insensitive and nonspecific for the vascular changes of AVN in bone. To further confound the issue, changes in other disorders, such as steroid osteopathy20 and epiphyseal dysplasia,63 mimic the radiographic changes of LCP in its later stages.


Single Photon Emission Compute Tomography Femoral Head Epiphyseal Growth Plate Deep Femoral Artery Transient Osteoporosis 
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  • James J. Conway

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