Figure 5.

Radiographs of the hips of a child with LCPD of the right hip that was not treated. In Stage III of the disease (a), the femoral epiphysis is severely flattened. The details of changes in the proximal femur are shown in the tracing (b); the femoral epiphysis, consisting of new bone that has formed (red) on either side of the necrotic part of the epiphysis (black), has “mushroomed” well beyond the margins of the metaphysis (green). In response to mushrooming of the epiphysis, there have been repeated attempts to increase the width of the metaphysis by remodeling of the neck (purple lines). The disease healed and at skeletal maturity, there is coxa magna, a short neck, and an aspherical femoral head (c).