THE PROGNOSTIC VALUE AND SIGNIFICANCE OF SERIAL BONE-SCINTIGRAPHY IN LEGG-CALVE-PERTHES DISEASE

We reviewed 44 consecutive patients treated for Legg-Calve-Perthes dis ease who underwent serial technetium 99m diphosphonate bone scintigrap hy. The average follow-up was 4.4 years. The bone-scintigraphy classif ication characterizes the A pathway by early lateral column formation not seen in the B pathway. Pathway A had 20 hips. The average age at p resentation was 6.1 years. At last follow-up, this group had an averag e Mose classification of 1.2 and Catterall score of 2.4, without any p atient having ''head-at-risk'' signs or requiring operative treatment. Pathway B had 20 hips. The average age at presentation was 5.8 years. At last follow-up, this group had an average Mose classification of 5 .2, a Catterall score of 3.5, and 18 patients had head-at-risk signs, with 11 requiring operative treatment. Our bone-scintigraphy classific ation preceded the radiographic head-at-risk signs by an average of 3 months, allowing earlier treatment and correlated with subsequent femo ral head involvement.