ORUK Course Perthes Disease

Question 1

What are the clinical features?

Answer 1

1 - Hip pain that can be referred to thigh or knee

2 - Limp

3 - LLD

4 - Restricted hip abduction and internal rotation

Question 2

What is the Differential diagnosis?

Answer 2

Unilateral:

1. DDH
2. Infection
3. Idiopathic AVN
4. Meyer’s dysplasia

Bilateral:

1. Skeletal dysplasias - MED, Spondyloepiphyseal dysplasia
2. Metabolic - Hypothyroidism, Hypophosphatemic ricketts, mucopolysacharidoses
3. Storage diseases - Gauchers
4. Others - steroid use, chemotherapy, radiotherapy

Question 3

What is Meyer’s Dysplasia?

Answer 3

Question 4

What is the Waldenstrom staging system?

Answer 4

Question 5

What is hinge abduction?

Answer 5

Question 6

What are Caterall’s head at risk poor prognostic signs?

Answer 6

Question 7

What is a rating system at maturity for Perthes?

Answer 7

Question 8

Explain the Herring Classification?

Answer 8

Question 9

What are the aims of management?

Answer 9

Question 10

What are the goals of early surgical containment in Perthes?

Answer 10

Question 11

What are the types of early surgical containment possible?

Answer 11

Question 12

What are the surgical options in the late stage of Perthes?

Answer 12

Question 13

Who described the surgical hip dislocation & femoral head reduction osteotomies?

Answer 13

Ganz in 2001 for the hip dislocation

Ganz in 2009 for the head reduction osteotomy