[Perthes' disease, symptomatic atypical juvenile osteochondroses of the femoral epiphysis and skeletal retardation (author's transl)].

A classification of atypical femoral osteochondroses with children is offered and explained by pertinent examples. In every single case has the diagnosis Perthes disease to be confirmed by securing a skeletal retardation by means or the carporadiogram. If there is no adequate skeletal retardation present or if it is exceedingly high, and if the children are more than 9 years old at the beginning, or if the course of the disease is unusually slow, we have to take into consideration the occurrence of a symptomatic osteochondrosis of the femoral epiphysis. Symptomatic in this context does not mean painful as in the anglo-american literature but rather "due to a special known etiology". In the majority of cases, then, we are confronted with a local manifestation of systemic osteochondrodystrophy. It's spondyloepiphyseal character can best be verified by a lateral X-ray of the lower dorsal and dorsolumbar spine, apart from an X-ray of the hand. Familiar occurrence, bilateral involvement, diminished height and relative early onset do equally point to a systemic underlying osteochondrodystrophic disease. Different symptomatic basic diseases, however, may also be represented by those signs, including skeletal retardation.