THE EARLY ROENTGENOGRAPHIC CHANGES IN ESSENTIAL COXA PLANA; THEIR SIGNIFICANCE IN PATHOGENESIS

¹ From the Department of Radiology and Pediatrics, the Medical School, University of Pittsburgh, and the Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

1. Generalized retardation of skeletal maturation was present in all but 1 of 30 patients.

2. The affected femur was displaced slightly in all patients.

3. The first roentgenographic changes in the EOC were segmental fracture, flattening, and sclerosis, in that temporal order, in the anterior superior lateral quadrant of the EOC. A strip of gas density filled the space between the edges of the fracture and the space between the edge of the EOC and its overlying cartilage directly peripheral to the fracture in several patients.

4. The early roentgenographic changes are best seen in the "frog" position and are usually invisible in the standard frontal projections of the hips.

5. Metaphyseal defects were not seen in the first examination in any patient, but were clearly visible in many cases 4 to 12 months later. They were always radiolucent and were always located in the anterior segment of the metaphysis, directly beneath the cartilage plate and the fractured and flattened ventral segment of the EOC.

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