Avascular Necrosis

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Avascular Necrosis:

Avascular Necrosis Lindsay McDonald, Stephanie Picerno, & Malerie Veillon 6/16/13


Osteochondroses Group of Disorders Self-Limiting Often Idiopathic 4 Phases References: 1, 2


Phases 1. Early Phase 2. Phase of Revascularization 3. Phase of Bone Healing 4. Phase of Residual Healing References: 1, 2


Diagnosis/Prognosis Early Stages: best detected with MRI Late Stages: best detected with radiographs Prognosis variable Reference: 3


Legg-Calve- Perthes ’ Femoral Head/Neck Boys 3-11 Idiopathic Reference: 1


Prognosis Factors include: Age of onset Amount of femoral head involved Complications Reference: 1


Treatment Not Always Required Prevent Deformity Surgery References: 3


MRI Image 1 Reference: 4 Image 2


Radiograph Reference: 6


Radiograph References: 2,5

Clinical Presentation:

Clinical Presentation Limited A/PROM Antalgic Gait


Questions 1. Based on the image in slide 10, what interventions would be most appropriate? 2. What signs and symptoms would cause you as the treating therapist to refer the patient back to the physician after initial diagnosis of Legg-Calve- Perthes ?


References 1. Salter RB. Textbook of Disorders and Injuries of the Musculoskeletal System. Baltimore, MD: Lippincott Williams & Wilkins;1999. 2. McKinnis LN. Fundamentals of Musculoskeletal Imaging. Philadelphia, PA: F.A. Davis Company; 2010. 3. Nichols, L. Pediatric Physical Therapy. St. Augustine, Florida: The University of St. Augustine for Health Sciences; 2012. 4. Imhof H, Breitenseher M, Trattnig S, et al. Imaging of avascular necrosis of bone. Eur Radiol. 1997; 7:180-186. 5. Hale JM, Doyle SM. Legg-Calve- Perthes Disease: An Overview. Hospital for Special Surgery web site. 2012. Available at: http://www.hss.edu/conditions_legg-calve-perthes-disease-overview.asp. Accessed June 15, 2013. 6. Pappas JN. The Musculoskeletal Crescent Sign. Radiology. 2000;217:213-214

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