Sa. Hoffinger et al., MAGNETIC-RESONANCE EVALUATION OF METAPHYSEAL CHANGES IN LEGG-CALVE-PERTHES DISEASE, Journal of pediatric orthopedics, 13(5), 1993, pp. 602-606
Twenty involved hips in 16 patients with Legg-Calve-Perthes disease (L
CP) were studied with both plain radiographs and magnetic resonance im
aging (MRI) scans to better evaluate the existence of ''metaphyseal''
changes. Thirty-four sets of radiographs and MRI scans were reviewed i
n a blinded fashion and compared for the presence and location of thes
e changes. Of 23 hips with plain radiographic metaphyseal changes, 11
showed no such changes on MRI scans (48%). Twelve hips did show MRI ch
anges located in the anterior metaphysis. One hip studied three times
had a discrete cystic change located in the central metaphysis. Of 11
hips with no plain radiographic changes in the metaphysis, five showed
metaphyseal changes on MRI. Metaphyseal changes in LCP remain poorly
understood. Even with use of MRI, fine distinction between physis and
metaphysis still proved difficult. It appears that most metaphyseal ch
anges are physeal and epiphyseal irregularities. A few hips have truly
metaphyseal lesions. The significance of these ''cysts'' is unclear.