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Pediatrics Case 12 Diagnosis

LCP Disease is diagnosed with AP and frog leg lateral x-rays. There are four classification stages for LCP: initial, fragmentation, reossification and healed. It is important to note that an x-ray may be normal in the initial stages, and an MRI may be warranted if symptoms persist.

Classification

X-ray characteristics

Initial

- Smaller, sclerotic epiphysis
- Medial joint space widening
- Caffrey’s/crescent sign: subchondral lucent sign

Fragmentation

- Mixed areas of radiolucency and radiodensities due to bone reformation

Reossification

- Changes in shape of the femoral head and neck
- More radiodensities and new bone forms

Healed

- Residual deformities in the proximal 1/3 of the femur

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