The haemodynamics of Perthes' disease. An intraosseous venographic study combined with measurement of the intramedullary pressure.

Intraosseous venography and measurement of intramedullary pressure have been carried out in the metaphyses of 55 patients with unilateral Perthes' disease. Flow of the opaque medium into the diaphysis is the most important finding in intraosseous venography of the metaphysis. This was related to a rise of intramedullary pressure which indicates the presence of venous congestion within the metaphysis. While such congestion was seen both in the sclerotic stage and the segmentation stage, it was not related to the severity of Perthes' disease as judged by Catterall's [1] classification. Such venous congestion could be relevant to the pathogenesis of Perthes' disease, but there are probably different factors which determine the prognosis.