Normal and Abnormal Growth at the Upper End of the Femur

Morgan, J. D.; Somerville, E. W.

doi:10.1302/0301-620x.42b2.264

Cited by 49 publications

(11 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The etiology of cam‐type deformities is unclear. Early hypotheses suggest that the deformity results from growth disturbances of the proximal femur (28–33); growth disturbances of the head and neck, such as a delayed separation of the common physis or an eccentric closure of the capital epiphysis, will affect the anterosuperior area of the head–neck junction and result in similar alterations to those seen in our study. Several anatomic variations were described that could correspond to the radiologic finding of a cam‐type deformity at the anterosuperior position of the proximal femur, including an osseous bar extending from the head to the superior tubercle of the intertrochanteric line described in 1899 (33, 34), an osseous prominence described as eminentia in 1904 (33–36), and concavities called imprints or cervical fossa in 1924 (34, 36).…”

Section: Discussionsupporting

confidence: 77%

Prevalence of cam‐type deformity on hip magnetic resonance imaging in young males: A cross‐sectional study

Reichenbach¹,

Jüni²,

Werlen³

et al. 2010

Arthritis Care & Research

169

144

View full text Add to dashboard Cite

Objective. To determine the prevalence of cam-type deformities on hip magnetic resonance imaging (MRI) in young males.Methods. This was a population-based cross-sectional study in young asymptomatic male individuals who underwent clinical examination and completed a self-report questionnaire. A random sample of participants was invited for MRI of the hip. We graded the maximal offset at the femoral head-neck junction on radial sequences using grades from 0 to 3, where 0 ‫؍‬ normal, 1 ‫؍‬ possible, 2 ‫؍‬ definite, and 3 ‫؍‬ severe deformity. The prespecified main analyses were based on definite cam-type deformity grades 2 or 3. We estimated the prevalence of the cam-type deformity adjusted for the sampling process overall and according to the extent of internal rotation. Then we determined the location of the deformity on radial MRI sequences. Results. A total of 1,080 subjects were included in the study and 244 asymptomatic males with a mean age of 19.9 years attended MRI. Sixty-seven definite cam-type deformities were detected. The adjusted overall prevalence was 24% (95% confidence interval [95% CI] 19 -30%). The prevalence increased with decreasing internal rotation (P Ͻ 0.001 for trend). Among those with a clinically decreased internal rotation of <30°, the estimated prevalence was 48% (95% CI 37-59%). Sixty-one of 67 cam-type deformities were located in an anterosuperior position. Conclusion. Cam-type deformities can be found on MRI in every fourth young asymptomatic male individual and in every second male with decreased internal rotation. The majority of deformities are located in an anterosuperior position.

show abstract

Section: Discussionsupporting

confidence: 77%

Prevalence of cam‐type deformity on hip magnetic resonance imaging in young males: A cross‐sectional study

Reichenbach¹,

Jüni²,

Werlen³

et al. 2010

Arthritis Care & Research

169

144

View full text Add to dashboard Cite

show abstract

“…It increases shortly after birth to about 145" at 18 months (Murakami 1959, Ravelli 1953. This infantile coxa valga is attributed to vigorous growth of the medial part of the crescentric growth plate in early infancy and lasts until the abductor muscles stimulate the development of the greater trochanter, when valgus decreases (Morgan and Somerville 1960). Valgus decreases to about 135" by the age of 6 years and remains stationary until adolescence, when there is a mild decrease to about 132" (Shands and Steele 1958).…”

Section: Femoral Inclinationmentioning

confidence: 99%

Developmental Changes in the Femur and Acetabulum in Spastic Paraplegia and Diplegia

Beals

1969

Develop Med Child Neuro

114

View full text Add to dashboard Cite

SUMMARY ‘Normal’ mean value curves were constructed from data in the literature for the acetabular index, femoral inclination, and femoral anteversion in relation to age. These were compared to the mean values found in a group of 40 patients with spastic paraplegia and diplegia. The angle of inclination was usually normal in these spastic children, but anteversion was markedly increased. Decrease in the acetabular index in these children was related to the duration of ambulation. The percentage of the femoral head uncovered by the bony acetabulum correlated with the acetabular index. Neither anteversion nor the angle of inclination correlated with lateral displacement of the femoral head until 40 per cent or more of the femoral head was displaced beyond the bony acetabulum. With subluxation of 40 per cent or more, anteversion and femoral inclination increased proportionately. The pathogenesis and therapeutic implications of femoral and acetabular defoi mity in spastic paraplegia and diplegia are discussed. RÉSUMÉ Altérations au cours de la croissance du fémur et de la cavité cotyloide dans la paraplégie spastique et la dipégie Des courbes de valeur moyenne ‘normale’ ont étéétablies à partir des données de la litterature pour l'index cotylo'idien, l'inclinaison fémorale et l'anteversion femorale en rapport avec l'age. Ces valeurs ont été comparers avec les valeurs moyennes observees dans un groupe de 40 malades atteints de paraplegie spastique ou de diplegie. L'angle d'inclinaison était habituellement normal chez ces enfants spastiques mais l'anteversion était notablement accrue. Une baisse de l'index cotylo'idien chez ces enfants était reliée a la duree de la marche. Le pourcentage de la tete femorale non recouverte par le cotyle était en relation avec l'index cotyloidien. Ni l'anteversion, ni l'angle d'inclinaison n'etait relie avec le deplacement lateral de la tSte femorale a moins que 40 pour cent ou plus de la tete femorale ne fut deplacee en dehors du condyle. Avec des subluxations de 40 pour cent ou plus, l'anteversion et l'inclinaison femorale s'accroissaient proportionnellement. La pathogenie et les implications therapeutiques des deformations f6morales et cotylo'idiennes dans la paraplegie spastique et la diplegie sont discutees. ZUSAMMENFASSUNG Wachstwnsalteration des Femur und des Acetabulum bei spastischer Paraplegie und Diplegie Aus Literaturangaben sind fiir einen Index des Acetabulum, fur die Neigung und fur die Anteversion des Femur Mittelwerte gebildet und diese in Relation zum Alter in ‘Norm‐kurven’ graphisch dargestellt worden. Man hat diese mit den Mittelwerten verglichen, die eine Untersuchung von 40 Patienten mit einer spastischen Paraplegie und Diplegie ergeben hatte. Der Neigungswinkel war bei den spastischen Kindern in der Regel normal, dagegen war die Anteversion auffallend vergroBert. Die Verringerung des Acetabulum‐Index bei diesen Kindern war davon abhangig, wie lange sie schon liefen. Der von dem knbchernen Acetabulum unbedeckte Anteil des Femurkopfes stand in Beziehung zum Acetabulu...

show abstract

“…Note the left femur is shortened, slightly laterally bowed with some sclerosis in the diaphysis to the limb bud: however, the cause in the great majority of children remains unknown. Abnormality in development of the normal vascular pattern in the limb has been suggested by Morgan and Somerville [4], Hootnick et al [5] and more recently by Szeizel et al [6], who looked at the association between smoking during pregnancy and congenital limb deficiency. Although the major deficiency is usually in one segment of the limb, a lesser degree of shortening in the other segments of the limb, which adds to the overall length discrepancy is extremely common and must be recognized.…”

Section: Etiologymentioning

confidence: 94%