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January 2009 Radiology Quiz
This patient is a 5 year old male who presents to the ED2 with the chief complaint of left hip and groin pain. The following X ray is shown.
Questions:
1. Describe what you see?
2. Physical exam would show:
- Decreased range of motion (ROM), particularly with internal rotation and abduction
- Painful gait
- Atrophy of thigh muscles secondary to disuse
- Muscle spasm
- Leg length inequality due to collapse
3. How would you manage this patient?
- Goals of treatment of Legg-Calve é -Perthes disease
- Achieve and maintain ROM
- Relieve weight bearing
- Containment of the femoral epiphysis within the confines of the acetabulum
- Orthopedic Consultations
4. Complications include:
- Legg-Calve-Perthe's Disease may result in femoral head deformity and degenerative joint disease.
- The femoral head may be distorted permanently.
Trivia: In the Lynyrd Skynyrd’s song “Gimme Three Steps”, where was the bar in that song located?
This is based on a true story. Lead singer Ronnie Van Zant, who was 18 at the time, used a fake ID to get in a bar while his band mates Gary Rossington and Allen Collins waited for him in a truck. Van Zant danced with a girl named Linda, whose boyfriend came up to Ronnie and reached for something in his boot. Figuring he was going for a gun, Van Zant told him to give him a few steps and he would get out. He ran to the truck, and he, Rossington, and Collins wrote this that night.
It's local legend that the song takes place in Bowling Green, Kentucky. After a gig at the Tobacco Warehouse, the boys from Skynyrd went down the road to a bar in town called The Little Brown Jug, thus "I was cuttin' the rug, down a a place called The Jug," which is where Ronnie Van Zant ran into an angry local man with a gun.
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