Understanding Legg-Calvé-Perthes disease
Legg-Calvé-Perthes disease, which affects between five and 10 of every 100,000 children each year, is so rare that it can sometimes be challenging for clinicians to know how best to care for affected patients.
That’s why in 2011 a group of pediatric orthopaedic specialists led by Texas Scottish Rite Children’s Hospital created an international study group dedicated to using research to improve the care of kids with Perthes, a hip disorder characterized by a loss of blood flow to the immature femoral head. Children’s National orthopaedic surgeon Benjamin Martin, M.D., has participated in the group since its launch.
Recently, Dr. Martin and two study group colleagues published a review study that outlines common imaging modalities used in the diagnosis and treatment of Perthes disease.
“There are many imaging options out there, including recent advances in MRI, that can add to our knowledge of the disease and how to treat it so kids have optimal outcomes,” Dr. Martin says. “Our goal was to review what’s out there, how it’s used, and identify any shortcomings of these approaches for this particular patient population.”
The authors note that imaging, in various forms, has been a crucial contributor to understanding and treatment of this disease since it was first discovered. Today, radiography remains the most common imaging technique used to diagnose and follow Perthes over time. However, some MRI applications may offer additional insight into the disorder.
Perfusion MRI allows for early understanding of extent of disease and perfusion patterns may correlate with outcomes. Diffusion weighted imaging (DWI) MRI is another promising avenue for tracking disease progression. Additionally, dynamic MRI might provide range of motion assessments that could be used in the surgical planning process.
This study was one of a handful that the international Perthes group has published so far, with several more currently under development. Exploring treatments and technology applications will enhance early diagnosis and treatment for Perthes, which is a crucial component of treatment success and improved quality of life for affected children.