Unexpected MRI findings in clinically suspected Legg-Calvé-Perthes disease.

Abstract:

BACKGROUND:In the setting of clinically suspected Legg-Calvé-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis. OBJECTIVE:To determine the frequency of unexpected causes of hip pain as identified by MRI in children with clinically suspected LCP disease and negative/equivocal radiographs. MATERIALS AND METHODS:All pediatric contrast-enhanced MRI examinations of the pelvis and hips performed between January 2000 and February 2009 to evaluate for possible LCP disease in the setting of negative/equivocal radiographs were identified. MRI examinations performed to evaluate for secondary avascular necrosis were excluded. Imaging reports were retrospectively reviewed for unexpected clinically important causes of hip pain. RESULTS:Thirty-six pediatric patients underwent contrast-enhanced MRI examinations for clinically suspected LCP disease in the setting of negative/equivocal radiographs. Twenty-two (61%) imaging studies were normal, while four (11%) imaging studies demonstrated findings consistent with LCP disease. Ten (28%) imaging studies revealed unexpected clinically important causes of hip pain, including nonspecific unilateral joint effusion and synovitis (n=7, juvenile chronic arthritis was eventually diagnosed in 3 patients), sacral fracture (n=1), apophyseal injury (n=1), and femoral head subluxation (n=1). CONCLUSION:MRI frequently reveals unexpected clinically important causes of hip pain in children with suspected LCP disease and negative/equivocal radiographs.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Lobert PF,Dillman JR,Strouse PJ,Hernandez RJ

doi

10.1007/s00247-010-1841-1

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

369-73

issue

3

eissn

0301-0449

issn

1432-1998

journal_volume

41

pub_type

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