Value of ultrasound diagnosis in Legg-Calvé-Perthes disease

Ultrasound examination of the hip joints in cases of the painful hip in childhood is routinely performed according to the advised standard sections of the German Society for Ultrasound in Medicine (DEGUM) at the special surgery of paediatric orthopaedics of the Orthopaedic University Clinic Magdeburg. Between 1993 and 2000 we performed 418 sonographic examinations of painful hip joints in 153 children. We identified 53 children (159 sonograms) with coxitis fugax, 47 children (188 sonograms) with Morbus Perthes, 28 children with epiphysiolysis capitis femoris, and three children with septic arthritis. In 15 cases (30 sonograms) no sonopathologic changes were observed. However, only in seven cases where ultrasound examination failed to reveal pathological changes, the cause of painful hip was identified by means of radiation depending X-ray or MRI. Sonograms of children with Morbus Perthes were further used to evaluate for stage differentiation and potential surgical treatment. Thus, we could show that ultrasound examination is a powerful tool for identifying the variety of underlying causes of painful hip in childhood and should be used as method-of-choice especially in children to avoid unnecessary radiation exposure.