In Legg–Calvé–Perthes disease, which prognostic classification assesses the lateral pillar of the femoral head on the AP radiograph during the fragmentation stage to predict outcome?
- A Catterall classification — divides femoral head into 4 groups by extent of involvement
- B Stulberg classification — assesses hip sphericity at skeletal maturity
- C Herring lateral pillar classification — Group A: no density loss; Group B: >50% height maintained; Group C: <50% height maintained ✓
- D Salter–Thompson classification — based on subchondral fracture extent
Explanation
The Herring lateral pillar classification (1992) divides the femoral head into three pillars on AP view during the fragmentation stage; the lateral pillar's height relative to normal is the key prognostic indicator. Group A: lateral pillar maintained, excellent prognosis; Group B: >50% lateral pillar height retained, intermediate prognosis — containment treatment may benefit children >8 years; Group B/C and C: <50% height retained, poor prognosis with high risk of coxa magna and early arthritis. Catterall was earlier but less reproducible; Stulberg grades radiographic outcome at maturity rather than predicting it.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.