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Left hip aspiration and culture under fluoroscopic guidance
4%
125/2890
Continued activity limitation and bracing
41%
1190/2890
Femoral or pelvic osteotomy
37%
1075/2890
Core decompression of the femoral head
10%
296/2890
Work-up for underlying metabolic bone disease
6%
183/2890
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This patient is presenting with late stage Legg-Calve-Perthes (LCP)disease. The radiographs and MRI scan demonstrate density changes and collapse of the femoral head consistent with lateral pillar group B. Herring et al evaluated the effect of LCP treatment on outcome. They found that patients >8 y.o. at the time of onset, with a hip in the lateral pillar B group or B/C border group had a better outcome with surgical treatment including either a femoral or pelvic osteotomy. Group-B hips in children <8 y.o. at the time of onset had favorable outcomes unrelated to treatment, whereas group-C hips in children of all ages frequently have poor outcomes regardless of treatment. McAndrew et al performed an avg 47 year f/u of patients with LCP disease. Significant correlations were found between clinical outcome and Catterall head-at-risk signs, femoral head-size ratio, and age at onset of the disease.
3.2
(66)
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