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The sagging rope sign in achondroplasia—different from Perthes’ disease

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Abstract

Objective

The sagging rope sign is a radio-opaque line, seen on radiographs of the hips, with Perthes’ disease. The main purpose of this study was to determine the incidence, cause and importance of this sign in achondroplasia, and to reveal how it differs from in Perthes’ disease.

Design

Serial radiograms, along with 2-dimensional and 3-dimensional CT images were studied in 42 achondroplasic patients.

Patients

Forty-two achondroplasic patients, reported at our institute (for routine outpatient consultation, spine surgeries, deformity corrections, limb-lengthening procedures) were included in this study. There were 26 males and 16 females.

Results

The sign was observed bilaterally, in all patients. Evaluation of CT images revealed spherical heads, with presence of circumferential overhang in all hips. This circumferential overhang, seen on 3-D CT scan, corresponded to the sagging rope sign on radiographs.

Conclusions

Presence of the sagging rope sign in bilateral hips is a characteristic feature of achondroplasia. It usually appears before epiphyseal closure. Its cause, incidence, and nature differ from Perthes’ disease, and its presence does not carry a bad prognosis in achondroplasia.

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Author information

Authors and Affiliations

  1. Department of Paediatric Orthopaedics, College of Medicine, Guro Hospital, Korea University, # 80, Guro-Gu, Guro-dong, Seoul, South Korea

    Viraj Uttamrao Shingade

  2. 135, Banerjee lay out, Post parvati nagar, Nagpur, Maharashtra, India, 440027

    Viraj Uttamrao Shingade

  3. Department of Paediatric Orthopaedic Surgery, College of Medicine, Guro Hospital, Korea University, # 80, Guro-Gu, Guro-dong, Seoul, South Korea

    Hae-Ryong Song

  4. Department of Orthopaedic Surgery, College of Medicine, Guro Hospital, Korea University, # 80, Guro-Gu, Guro-dong, Seoul, South Korea

    Seok-Hyun Lee & Seung-Woo Suh

  5. Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, South Korea

    Chang-Wug Oh

  6. Department of Orthopaedic Surgery, Korea University, Ansan Hospital, 516 Gojan dong, Danwon gu, Ansan, Gyeonggi do, 425-020, South Korea

    Jun-Seok Hong

Authors
  1. Viraj Uttamrao Shingade
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  2. Hae-Ryong Song
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  3. Seok-Hyun Lee
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  4. Seung-Woo Suh
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  5. Chang-Wug Oh
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  6. Jun-Seok Hong
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Corresponding author

Correspondence to Viraj Uttamrao Shingade.

Additional information

Study conducted at: Department of Paediatric Orthopaedics, Korea University, Guro Hospital, #80, Guro-Gu, Guro-dong, Seoul, Korea

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Shingade, V.U., Song, HR., Lee, SH. et al. The sagging rope sign in achondroplasia—different from Perthes’ disease. Skeletal Radiol 35, 923–928 (2006). https://doi.org/10.1007/s00256-006-0166-5

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  • DOI: https://doi.org/10.1007/s00256-006-0166-5

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