The classification of Stulberg et al is used to evaluate a patient with Legg-Calve-Perthes disease.
Parameters:
(1) sphericity of the femoral head (spherical, ovoid, mushroom-shaped, umbrella-shaped, flat)
(2) length of the femoral neck
(3) steepness of the acetabulum
(4) coxa magna
Shape of the Femoral Head
Other Findings
Class
spherical
normal acetabulum, normal neck, no coxa magna
I
spherical
one or more of coxa magna, short neck, steep acetabulum
II
ovoid
NA
III
flat
coxa magna or steep acetabulum
IV
flat
no coxa magna and normal acetabulum
V
A spherical femoral head matches a circular template in AP and laterial views.
A flat femoral head has one third or more of femoral head contour resembling a flat line on at least 1 view.
An ovoid femoral head is neither spherical nor flat.
Coxa manga: diameter of involved femoral head >= 1.1 times that of uninvolved side (in unilateral disease).
The femoral neck is shorter than normal if the tip of trochanter is located proximal to the center of the head.
Slope of acetabulum: measured at most lateral portion of acetabulum on AP X-ray. A steep acetabulum has a slope that is parallel with horizontal or inclined upward.
To read more or access our algorithms and calculators, please log in or register.
