PSEUDOCOXALGIA

A review of fifty cases of idiopathic pseudocoxalgia (Legg-Calvé-Perthes disease) followed into adult life for periods of eleven to thirty years (average seventeen years) after diagnosis shows:

1. In the whole series rather more than one-third of the patients developed hips which were normal or nearly normal.

2. An equal number had hips which could only have been considered "fair."

3. About one quarter had hips which gave pain and which showed marked loss of movement and gross degenerative changes radiologically.

Judged from the point of view of symptoms, the results were better than the foregoing would suggest. Three-quarters of the patients were fully active and free from pain but only two-fifths had hips which were radiologically good. It is possible that such apparently good results are unlikely to be permanent, and I hope, therefore, to continue this follow-up for another ten or fifteen years. It can, however, be concluded at this stage that an immediate good result is likely to be maintained at least until the age of twenty-five years, even though half of such patients will have radiologically abnormal hips.

There is a characteristic pattern of deformation of the femoral head and neck in the adult resulting from this condition in childhood, based on the degree of flattening of the head and shortening of the neck.

The end-results are better in adequately treated cases.

Two cases are reported in which osteochondritis dissecans developed as a late complication.