Investigating The Value Of Ultrasound In Diagnosis Of Perthes Disease

BackgroundLegg-Calvé-Perthes disease,named osteochondritis of the femoral head, is an avascular necrosis of the femoral head in children.It is the self-cure and self-limited disease.It betide to children of the age of 2 to 14 years.Mostly on the age of 4 to 10 years.The male female ratio is 4-5:1,the half hip occupy 90%,it is one of the most common and considerable femoral articulation disease.The symptom is limp and pain of hip.But abnormality of the femoral head is very serious in later period,so wu should diagnose the disease as early as possible.The diagonosis depends on X ray,MRIand ECT.X ray can display the change of bone very well,but cann't display the chang of soft bone and tissue,meanwhile it's radioactive.MRI is very sensitive,it can display the soft tissue very well,but it cann't show the local blood,and it's very expensive.ECT can show the blood of femoral head,but it's radioactive ,expensive and the result maybe fake negative.ultrasound can find the change of femoral head,synovial membrane and hip joint early.And we can use CDFI to watch the change of the femoral head blood ,and it's cheap,convenient,non-radioactive.So ultrasound is very useful for the diagonosis of Perthes disease.ObjectiveTo observe the characteristics of hip joints and investigate the value of ultrasound in evaluation of blood flow of hip joints in Perthes disease.MethodsTwenty-nine hip joints with Perthes'disease were examined with ultrasound imaging including CDFI by the same doctor in order to observe the characteristics of hip joints blood supply, while the normal hip joints in the same 29 cases were examined as the controls. The series consistsed of 26 boys and 3 girls(right 10 cases,left 19 cases).According to Catterall's classification,2 cases were graded as group I,8 cases were graded as groupⅡ,12 cases were graded as groupⅡ, 7 cases were graded as groupⅣ.The mean age of patients was eight years and seven months.The children with Perthes'disease took supine position. The hip joints were examined with ultrasound imaging from separately from inside to outside carries on longitudinal and crosswise sweeps looks up to observe the articular surface of femoral head and the thickness of synovial membrane of articular capsule. The hip joints'blood supply were observed and graded with CDFI.ResultsThe articular surface of femoral head were found abnormality including the femoral head became flatted and broken.6 injured hip joints were detected the synovial membrane of articular capsule thicking,2 injured hip joints thining and 21 injured hip joints normality.A total of 8 injured hip joints were detected no blood signal,20 injured hip joints were detected blood signal decreasing,but only one injured hip joints were detected blood signal increasing.According to CDFI classification,8 cases were graded as group 0,19 cases were graded as group I,2 cases were graded as groupⅡ. According to Wirth classification,10 cases were graded as groupⅡ,18 cases were graded as groupⅡ, 1 cases were graded as groupⅣ.ConclusionsUltrasonography can correctly detect lesions and evaluate the blood supply of hip joints in patients with Perthes disease,it is useful for the diagnosis of Perthes disease.