Twenty-three hips in patients with Legg-Perthes disease and twenty-three
normal hips were studied. The intra-osseous pressure was measured in the
femoral neck in all forty-six hips and was found to be only slightly higher
in the hips with Legg-Perthes disease. However, after five milliliters of
saline solution was injected intra-osseously, the pressure was
significantly higher in the diseased hips than in the controls, and after
the pressure had stabilized at five minutes after injection the pressure
was even higher in the hips with Legg-Perthes disease. Intra-osseous
venography was also performed for all of the hips. All of the control hips
had a normal venogram, whereas the venograms in the hips with Legg-Perthes
disease were all either mildly or severely abnormal. The rise in the
intra-osseous pressure after saline stress in the hips with severe changes
on venography was significantly higher than the rise in the hips with mild
changes. Clinical Relevance: Intra-osseous venography and measurement of
changes in intra-osseous pressure might aid in the earlier diagnosis of
Legg-Perthes disease and prove to be useful monitors of the results of
treatment.