CONVENTIONAL RADIOGRAPHY AND BONE-SCINTIGRAPHY IN THE PROGNOSTIC EVALUATION OF LEGG-CALVE-PERTHES DISEASE

Purpose: The role of conventional radiography and bone scintigraphy in predicting the outcome of Legg-Calve-Perthes disease was investigated . Material and Methods: The 75 children reviewed (86 hips) were follow ed up to the primary healing of the disease. The findings at conventio nal radiography (obtained at presentation, at the time of maximum capi tal head involvement, and at the end of the healing process of the dis ease) were compared to early bone scintigraphy features. Results and C onclusion: Bone scintigraphy provided more accurate information concer ning the extent of the necrotic process than initial radiographs. More over it could determine revascularization and consequently the stage o f the disease. The method was, however, unable to predict the outcome of the disease in some of the cases, particularly if it was performed late after the onset of symptoms. Conventional radiography provided im portant information about other parameters such as ''head-at-risk'' si gns which facilitated treatment selection. Of these signs not only lat eral subluxation but also metaphyseal changes strongly predispose to s evere deformity of the hip joint.