Perthes Syndrome Research Articles

An unusual case of post-traumatic Perthes syndrome in adult

Post-traumatic Perthes syndrome in adults is a rare manifestation. It poses a management problem and treatment is based on aggressive and directed management of the cardiopulmonary systems associated with rapid recognition and treatment of progressive lesions. The result differs depending on the duration, mechanism and severity of the compression, which justifies extreme caution in the approach to these patients. We report the observation of a rare case in a patient, with a history of DALY under treatment and hypertension poorly monitored under treatment, admitted to intensive care for Perthes syndrome resulting from serious thoraco-abdominal trauma following to a fall from a crane and whose clinical evolution was satisfactory. The objective is to emphasize the beneficial effects of early treatment of this rare syndrome in adults.

Traumatic asphyxia in the young: report of two cases and literature review

BackgroundTraumatic asphyxia, also called masque ecchymotique, Ollivier’s syndrome, and Perthes syndrome, is a rare but serious form of chest trauma described for the first time by Ollivier in 1837. The purpose of this study is to report our experience with two cases of traumatic asphyxia and discuss their management in view of the relevant literature.ResultsDuring a 6-year period, the author treated 2 cases of traumatic (crush) asphyxia in a local teaching hospital. The two patients were males, aged 20 and 30 years and were crushed beneath their vehicles. The presenting symptoms and signs were irritability, dyspnea, cervicofacial cyanosis, petechiae, and sub-conjunctival hemorrhages. The second patient suffered multiple rib fractures, hemopneumothorax, pulmonary contusion, vertebral fracture, and paraplegia. Negative surgical exploration for suspected cardiac tamponade was performed in the first case, while the second was managed conservatively.The first patient survived whereas the second succumbed because of the associated injuries.ConclusionsDue to its widespread lesions, traumatic asphyxia should be looked upon as a systemic syndrome. Timely accurate diagnosis and supportive treatment save the majority of patients with traumatic asphyxia. In this rare syndrome, death may result from asphyxia secondary to thoracic compression or from the associated injuries.

Perthes Syndrome after Roll-Over Trauma

Roll-over trauma and associated traumatic entrapments frequently result in serious polytraumatisation. In rare cases, severe extrathoracic compressions and a protracted entrapment period can lead to Perthes syndrome, also known as traumatic asphyxia. The Perthes syndrome manifests itself by a triad of craniocervical cyanosis, facial petechiae and subconjunctival haemorrhages, enabling a rapid diagnosis based on these typical clinical features. In addition, a contusion of the heart, lungs or even the liver may occur as well as neurological and other ophthalmological complications. An early identification of this condition, the elevation of the upper body to allow adequate venous drainage in addition to ensuring sufficient oxygenation are essential for optimal therapy. In general, no long-term complications are to be expected for Perthes syndrome. The stasis usually disappears completely within a few months.

An Unusual and Fatal Case of Perthes’ Syndrome

Perthes syndrome includes cervical and facial cyanosis, subconjunctival haemorrhage, petechial haemorrhages on the face, neck, and upper chest, secondary to chest compression. We report a clinical case of Perthes’ syndrome in 3-year-old boy victims of chest crush by a tractor. Clinical examination found: a Glasgow score at 13/15, polypnea, tachycardia, hypotension; wound of the occipital scalp, a low abundance of hematuria, deformation of the left lower limb. Body scan: bilateral pneumothorax and pulmonary contusions, left hemothorax; lacerations at the medial and upper renal pole grade IV, a low abundance of retroperitoneal hematoma, fracture of the left femur. Biological assessment showed major metabolic disturbances with severe acute rhabdomyolysis and multi-visceral failure. Without clinical improvement, the patient died after 36 hours of intensive care.

Comparison of autopsy findings and injury severity scores in deaths due to traumatic asphyxia (perthes syndrome)

Traumatic asphyxia is a rare clinical syndrome usually caused by sudden and severe thoracic and/or thoracoabdominal compression. It presents with craniofacial cyanosis, petechiae, and subconjunctival haemorrhages. The present study employed a postmortem retrospective methodology to analyse autopsy findings and accompanying injuries in cases of death due to traumatic asphyxia.Four years of case files from a morgue department at a forensic medicine institute were searched and 53 cases of lethal traumatic asphyxia were found. These cases were then classified into groups and compared using the Injury Severity Score (ISS) and New Injury Severity Score (NISS) indices to measure trauma. ResultsThe individuals had died due to occupational (n = 28; 52.8%), farm (n = 10; 18.9%), traffic (n = 9; 17.0%) or household (n = 6; 11.3%) accidents. At the external examination, conjunctival petechiae (60.4%) and petechiae on the face/neck (52.8%); at the autopsy, subpleural petechiae (58.5%) and petrous ridge hemorrgahe (without skull base fracture) (56.6%) were the most common findings. A finding of petrous ridge hemorrgahe was very common in the cases without any accompanying injuries (Group A in which mean Injury Severity Score was 0.83 ± 0.98).Traumatic asphyxia is usually suspected from the given circumstances before an autosopy is performed. In cases without hospitalisation, any of the following signs may lead the physician to diagnose traumatic asphyxia as the cause of death: petechiae on the upper parts of the body and conjunctiva, petechiae on serous membranes (including subpleural regions), signs of petrous ridge haemorrhage without skull base fracture.

Perthes syndrome: a pediatric case

The traumatic asphyxia or Perthes syndrome is uncommon. It is a clinical syndrome associating an ecchymotic mask consisting of cervicofacial cyanosis, petechiae and subconjunctival hemorrhage to neurological and ocu¬lar symptoms. The authors report a pediatric case of 8-year-old boy who was a highway accident victim. He presented a cervicofacial cyanosis, petechiae and immediate massive bilateral sub-conjunctival hemorrhage. The attitude was limited to a clinical monitoring. The decline is twelve months.

Perthes Syndrome by Severe Gravitational Force

Purpose : To report two patients with petechial hemorrhages in the skin of the face and eyelids and subconjunctival hemorrhages after they were exposed to acute severe gravitational force. Methods : Two patients developed Perthes syndrome after they were exposed to an unrestrained acute increase of gravitational force in a park attraction. One of them lost his consciousness for few minutes. The mechanism behind this entity is the sudden rise in the cervicofacial venous system pressure. Results : In our two cases there were no long-term complications encountered and there was spontaneous resolution. Conclusion: Perthes syndrome independently of the cause can lead to ophthalmic, neurological and even life threatening consequences. Proper clinical examination is warranted upon evaluating a patient with such entity.

Syndrome de Perthes secondaire à une crise d’asthme : à propos d’un cas chez un enfant de 15 ans

Perthes syndrome, or traumatic asphyxia syndrome, is a rare clinical entity, associating cyanosis, cervicofacial petechiae and subconjunctival hemorrhage. It is usually secondary to chest trauma, but can occur in any situation of abrupt rise in intrathoracic pressure with closed glottis. In this paper, we present a case of Perthes syndrome that triggered an asthma attack for a child during surgery.

Pituitary and legg calve perthes syndrome - is there a connexion?

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Unfavorable hip stress distribution after Legg–Calvé–Perthes syndrome: A 25‐year follow‐up of 135 hips

To study the effect of hip and pelvis geometry on development of the hip after Perthes disease, we determined the resultant hip force and contact hip stress distribution in a population of 135 adult hips of patients who had been treated for Perthes disease in childhood. Contra-lateral hips with no record of disease were taken as the control population. Biomechanical parameters were determined by mathematical models for resultant hip force in one-legged stance and for contact hip stress, which use as an input the geometrical parameters assessed from anteroposterior radiographs. The mathematical model for stress was upgraded to account for the deviation of the femoral head shape from spherical. No differences were found in resultant hip force and in peak contact hip stress between the hips that were in childhood subject to Perthes disease and the control population, but a considerable (148%) and significant (p < 0.001) difference was found in the contact hip stress gradient index, expressing an unfavorable, steep decrease of contact stress at the lateral acetabular rim. This finding indicates an increased risk of early coxarthritis in hips subject to Perthes disease.

A fatal case of Perthes syndrome

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of this syndrome. Current treatment is symptomatic: urgent relief of chest compression and cardiopulmonary resuscitation if needed. Outcome may be satisfactory depending on the duration and severity of compression. Prolonged thoracic compression may sometimes lead to cerebral anoxia, irreversible neurologic damage and death. We report a fatal case of Perthes syndrome resulting from an industrial accident.

Perthes Syndrome associated with intramedullary spinal cord hemorrhage in a 4-year-old child: a case report

BackgroundPerthes Syndrome (Traumatic asphyxia) is rare, which is caused by sudden compressive chest trauma and characterized by subconjunctival hemorrhage, facial edema, craniocervical cyanosis, and petechiae on the upper chest and face.Case presentationWe present the case of a 4-year-old Caucasian girl who developed traumatic asphyxia associated with intramedullary spinal cord hemorrhage following thoracic compression.ConclusionWe have not found the association of Perthes syndrome with intramedullary spinal cord hemorrhage described in the medical literature. To our knowledge, the current case is the first report of Perthes Syndrome associated with intramedullary spinal cord hemorrhage.

Perthes syndrome associated with bilateral optic disc edema

Case report: Perthes syndrome, or traumatic asphyxia syndrome, results from a severe crush injury of the thorax. It manifests itself with facial and upper chest petechiae, subconjunctival hemorrhages, cervical cyanosis, and occasionally neurological symptoms. A patient who had been incarcerated under a block of marble presented with severe traumatic asphyxia syndrome complicated by pulmonary contusion, fractures of the right clavicle and the 8th and 9th ribs, minimal right hemothorax, liver contusion, and bilateral optic disc edema. Comments: To our knowledge, we present the first case of Perthes syndrome with bilateral optic disc edema.

Perthes syndrome associated with bilateral optic disc edema

<h2>Abstract</h2> Case report: Perthes syndrome, or traumatic asphyxia syndrome, results from a severe crush injury of the thorax. It manifests itself with facial and upper chest petechiae, subconjunctival hemorrhages, cervical cyanosis, and occasionally neurological symptoms. A patient who had been incarcerated under a block of marble presented with severe traumatic asphyxia syndrome complicated by pulmonary contusion, fractures of the right clavicle and the 8th and 9th ribs, minimal right hemothorax, liver contusion, and bilateral optic disc edema. Comments: To our knowledge, we present the first case of Perthes syndrome with bilateral optic disc edema.

Purpura thoracocervicofacial par compression thoracique : un nouveau syndrome de Perthes ?

A case of a major thoracocervicofacial purpura in a 16-year-old patient following a prolonged thoracic compression by his motor car is reported. The causative mechanism, equivalent to a Valsalva manœuvre is discussed. As the first case has been described and analyzed by Perthes, the authors suggest to call it « Perthes syndrome .

Influence of Small Daily Doses of Tetracycline* on the Clinical Course of Legg-Calv??-Perthes Syndrome

Influence of Small Daily Doses of Tetracycline* on the Clinical Course of Legg-Calv??-Perthes Syndrome

Legg — Calvé — perthes syndrome and related Osteochondroses of youth. By Charles Weer Goff, M.D., in association with N. M. Shutkin, M.D., and M. R. Hersey, M.D. pp. xxiii and 332; 123 figs., 15 tables, 2 nomographs, 10 graphs, $10.75. Charles C Thomas, Springfield, Ill. 1954

Legg — Calvé — perthes syndrome and related Osteochondroses of youth. By Charles Weer Goff, M.D., in association with N. M. Shutkin, M.D., and M. R. Hersey, M.D. pp. xxiii and 332; 123 figs., 15 tables, 2 nomographs, 10 graphs, $10.75. Charles C Thomas, Springfield, Ill. 1954