Analysis of Atrophy of Gluteal Muscles in Perthes Disease.

概要

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Cross-sectional area of the bilateral gluteus maximus, medius and minimus were measured in 22 cases with Perthes disease using CT scan at the following three levels: lower end of sacloiliac joint, upper end of acetabulum and mid-level between the sacroiliac joint and acetabulum. Summation of cross sectional area of these three levels was used to evaluate the degree of muscle atrophy. Percentage area of the affected site was calculated from that of the unaffected site in individual gluteal muscles. Radiological findings and clinical evaluations were compared with the percentage area. Patients admitted to hospital within 3 months of the onset of Perthes disease showed less atrophy in gluteus maximus than those admitted after 3 months (p<0.05). There was no correlation between muscle atrophy and Catterall classification or between muscle atrophy and the number of radiological findings of head at risk. Patients with both "tear shaped" signs and "pubic varus" signs on radiograph showed more atrophy in both gluteus maximus and medius than patients whith negative radiological signs (p<0.01). Patients who had Perthes disease before 7 years old showed less atrophy in gluteus maximus than those whose onset was after 7 years of age (p<0.05). Less muscle atrophy in patients admitted to hospital within 3 months suggested the benefit of early systematic treatment.
西日本整形・災害外科学会の論文