Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- presença de fatores de risco
- claudicação
- amplitude de movimento limitada na articulação do quadril
Другие диагностические факторы
- baixa estatura
- perda de massa muscular
- hiperatividade
- sinal de Trendelenburg
- sinovite
- dor no joelho
- dor na coxa
- dor na virilha/nádega
- comprimento assimétrico do membro
- pequeno trauma
Факторы риска
- sexo masculino
- idade entre 4 e 8 anos
- baixo nível socioeconômico
- estados hipercoaguláveis
- população urbana
- raça e latitude norte
- sinovite transitória do quadril
- derrame articular do quadril
- tabagismo passivo
- displasias esqueléticas
- anomalias congênitas
- trissomia do cromossomo 21
- distúrbios de comportamento
- endocrinopatia
Диагностические исследования
Исследования, которые показаны в первую очередь
- radiografia do quadril bilateral
Исследования, проведение которых нужно рассмотреть
- Hemograma completo
- velocidade de hemossedimentação sérica
- proteína C-reativa sérica
- cintilografia óssea
- ressonância nuclear magnética (RNM) dos quadris
Алгоритм лечения
com dor aguda
menores de 5 anos de idade
5 a 7 anos de idade
7 a 12 anos de idade
maiores de 12 anos de idade
Составители
Авторы
Andrew Wainwright, FRCS (Tr & Orth) Med
Consultant Orthopaedic Surgeon
Nuffield Orthopaedic Centre
Oxford
UK
Раскрытие информации
AW declares that he has no competing interests.
Dominique Knight, BSc, MBBS, FRCS
Consultant Paediatric Orthopaedic Surgeon
Bristol Royal Children’s Hospital
Bristol
UK
Раскрытие информации
DK declares that she has no competing interests.
Выражение благодарностей
Dr Andrew Wainwright and Dr Dominique Knight would like to acknowledge Dr Jwalant S. Mehta and Dr Sandeep Hemmadi, who wrote the original topic and whose work is largely reflected in the current version. JSM and SH declared that they had no competing interests.
Рецензенты
Phillip Thomas, FRCS (Orth)
Consultant Orthopaedic and Paediatric Orthopaedic Surgeon
Llandough Hospital
Vale of Glamorgan
UK
Раскрытие информации
PT declares that he has no competing interests.
Young-Jo Kim, MD, PhD
Associate Professor of Orthopaedic Surgery
Children's Hospital
Boston
MA
Disclosures
Not declared.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1981 Sep;63(7):1095-108. Abstract
Catterall A. The natural history of Perthes' disease. J Bone Joint Surg Br. 1971 Feb;53(1):37-53. Abstract
Salter RB, Thompson GH. Legg-Calvé-Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement. J Bone Joint Surg Am. 1984 Apr;66(4):479-89. Abstract
Herring JA, Neustadt JB, Williams JJ, et al. The lateral pillar classification of Legg-Calvé-Perthes disease. J Pediatr Orthop. 1992 Mar-Apr;12(2):143-50. Abstract
Canale ST, D'Anca AF, Cotler JM, et al. Innominate osteotomy in Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1972 Jan;54(1):25-40. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Artrite séptica
- Sinovite transitória do quadril
- Doença falciforme
More Differentials
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