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Legg-Calvé-Perthes Disease: MR Imaging Evaluation during Manual Positioning of the Hip-Comparison with Conventional Arthrography¹

¹ From the Departments of Radiology (D.J., T.A.G., D.Z., R.V.M., O.L.V.M.), Orthopaedic Surgery (P.A.M., J.R.K.), and Research Computing and Biostatistics (J.D.), Children's Hospital, 300 Longwood Ave, Boston, MA 02115; and the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (C.S.W., R.V.M., F.A.J.). Received May 14, 1998; revision requested July 13; final revision received December 2; accepted February 9, 1999. Supported in part by National Institutes of Health grant AR42396-04 (D.J., T.A.G., O.L.V.M.) and GE Medical Systems (all authors). Address reprint requests to D.J. (e-mail: jaramillo@a1.tch.harvard.edu).

PURPOSE: To evaluate the use of magnetic resonance (MR) imaging during manual positioning of the hip, or multipositional MR imaging, in an open-magnet configuration to study femoral head containment, articular congruency, and femoral head deformity in Legg-Calvé-Perthes disease.

MATERIALS AND METHODS: In 12 children with advanced Legg-Calvé-Perthes disease, multipositional MR imaging and conventional arthrography were compared in the assessment of containment, femoroacetabular congruency, and femoral head deformity. Images of the hips in several positions were compared subjectively and objectively.

RESULTS: MR imaging correlated well with arthrography for overall subjective assessment of severity of disease (r = 0.71, P = .01), with good interobserver agreement ( = 0.65, P < .001). MR images demonstrated all cases of hinge abduction shown arthrographically. However, MR imaging failed to depict one case of femoral head flattening. MR imaging correlated well with arthrography in the objective evaluation of joint fluid and lateral subluxation (r = 0.80, P < .01). MR imaging correlated poorly with arthrography in the measurement of sphericity of the femoral head.

CONCLUSION: Multipositional MR imaging with an open-magnet configuration was comparable to arthrography for demonstration of femoral head containment and congruency of the articular surfaces of the hip. In the evaluation of deformity, it performed less well.

Index terms: Bones, necrosis, 442.443 • Hip, arthrography, 442.122 • Hip, MR, 442.121411, 442.121412 • Hip, necrosis, 442.443 • Magnetic resonance (MR), comparative studies, 442.121411, 442.121412 • Magnetic resonance (MR), in infants and children, 442.121411, 442.121412, 442.443

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