The fate of the joint space in Legg–Calvé–Perthes-disease

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• 作者：Sandeep Vijayan (1)
  Ojas Mehta (1)
  George Jacob (1)
  N. D. Siddesh (1)
  Hitesh Shah (1)
  Benjamin Joseph (1)
  
• 关键词：Joint space width ; Articular cartilage thickness ; Degenerative joint disease ; Legg ; Calvé ; Perthes-disease ; Hip joint
• 刊名：Skeletal Radiology
• 出版年：2013
• 出版时间：March 2013
• 年：2013
• 卷：42
• 期：3
• 页码：341-345
• 全文大小：235KB
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• 作者单位：Sandeep Vijayan (1)
  Ojas Mehta (1)
  George Jacob (1)
  N. D. Siddesh (1)
  Hitesh Shah (1)
  Benjamin Joseph (1)
  
  1. Paediatric Orthopaedic Service, Kasturba Medical College, Manipal University, Manipal, 576 104, Karnataka State, India
  
• ISSN：1432-2161

文摘

Objective This study was undertaken to identify variations in the hip joint space in patients with healed Legg–Calvé–Perthes-disease (LCPD) and to correlate these changes with the radiological outcome of treatment. Methods The width of the joint space was measured on radiographs of 121 skeletally mature individuals with healed LCPD. The joint space width at the stage of healing in 79 patients was compared with the joint space at skeletal maturity. The hips were graded by the Stulberg classification and the femoral head radius was measured. Associations between the joint space width, the Stulberg class and the femoral head radius were tested. The reproducibility of measurement was tested by measuring 30 radiographs twice and computing the intra-class correlation coefficient (ICC). The joint space width was measured on radiographs of 25 patients taken both while recumbent and standing, to determine if the joint space alters on weight-bearing. Results The reproducibility of measurements was satisfactory; no difference was noted in the joint space in recumbent and weight-bearing films. Increased joint space was noted both at healing of the disease and at skeletal maturity; the width was minimally increased in Stulberg Class I hips and considerably increased in Class III, IV and V hips. There was a significant correlation between the increase in joint space and enlargement of the femoral head. Conclusions An increase in joint space width occurs quite frequently following LCPD; the increase is most evident in hips with a poor outcome. The implications of this observation need to be elucidated.