Catterall identified a number of signs indicating a patient with Legg-Calve-Perthes disease at significant risk of a poor clinical outcome because of significant collapse of the femoral head. The author is from Hospital for Sick Children in London.
Signs seen in the femoral head on the anteroposterior X-ray of the pelvis:
(1) transradiant "V" on the lateral side of the epiphysis (Gage's sign) associated with a small osteoporotic segment
(2) calcification lateral to the epiphysis (a large or small area in the anterior part of the viable lateral fragment of the epiphysis)
(3) lateral subluxation of the femoral head
(4) horizontal epiphyseal line
(5) diffuse metaphyseal changes
number of signs present =
= SUM(number of the 5 signs present)
Interpretation:
• minimum number: 0
• maximum number: 5
• A number of signs >= 2 indicates a femoral head "at risk" for a poor outcome.
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