PROGNOSIS IN PERTHES-DISEASE - A COMPARISON OF RADIOLOGICAL PREDICTORS

We compared the prognostic value of the Catterall grouping, the Salter -Thompson grading, the arthrographic shape of the femoral head, and th e Herring lateral pillar grouping during the fragmentation stage of Pe rthes' disease in 73 patients with 81 affected hips. Radiographs were available for study from the onset of the disease until skeletal matur ity. We used the Stulberg classification to assess outcome. The Herrin g grade and arthrographic sphericity proved to the best predictors of final outcome. Combining these two values further increased the predic tive value. All but one patient in Herring group A achieved an excelle nt outcome. In Herring group B, the age of the child and the sphericit y of the femoral head influenced the end result. If the child was less than seven years old at the onset of symptoms the prognosis was invar iably good and all spherical hips in group B had a good outcome with S tulberg grades 1 or 2. Moderately and severely deformed hips on arthro graphy resulted in Stulberg 3 and 4 hips. None of the hips in Herring group C had a normal appearance at maturity and the outcome was not si gnificantly influenced by the age at onset or the arthrographic appear ance.