US of the painful hip in childhood: diagnostic value of cartilage thickening and muscle atrophy in the detection of Perthes disease.

Abstract:

PURPOSE:To evaluate the combined use of several ultrasonographic (US) criteria in the detection of Perthes disease. MATERIALS AND METHODS:In a prospective study, 144 consecutive children with a painful hip underwent US. The thicknesses of the (a) anterior recess of the joint capsule, (b) cartilage of the femoral head, and (c) quadriceps muscle were assessed. Sixty-eight children with no symptoms, the control group, were also examined. RESULTS:The final diagnosis was transient synovitis (n = 58), Perthes disease (n = 21), slipped capital femoral epiphysis (SCFE; n = 5), or miscellaneous (n = 6). Fifty-four patients had no US or radiographic abnormalities, and symptoms disappeared during follow-up. The anterior recess in patients with transient synovitis was significantly wider than that in the other patients and control subjects (P < .001). Patients with Perthes disease showed significant cartilage thickening in the symptomatic hip compared with the other patients and control subjects (P < .001). Patients with Perthes disease and patients with SCFE showed significant atrophy of the ipsilateral quadriceps muscle compared with all other groups (P < .001). The combined use of these US criteria for the diagnosis of Perthes disease resulted in a positive predictive value of 95%, a negative predictive value of 95%, a sensitivity of 71%, and a specificity of 99%. CONCLUSION:The combination of several US criteria increases the diagnostic value of US of the painful hip in patients with Perthes disease.

journal_name

Radiology

journal_title

Radiology

authors

Robben SG,Meradji M,Diepstraten AF,Hop WC

doi

10.1148/radiology.208.1.9646790

subject

Has Abstract

pub_date

1998-07-01 00:00:00

pages

35-42

issue

1

eissn

0033-8419

issn

1527-1315

journal_volume

208

pub_type

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