Disturbances in Epiphyses in Growth Period.
—Valentin1 refers to the affections of the hip joint, of the scaphoid bone, etc., known as the Legg, Calvé, Perthes, Koehler or Osgood-Schlatter affections, and maintains that they have nothing in common with rachitis and that trauma is only an occasional factor. He looks on it as a congenital developmental anomaly, remaining latent until the period of most active growth and exercise. The anomaly is in the epiphyseal cartilage and its vicinity, near the growth center of the epiphyses. The arrangement of the vessels at this center causes a predisposition to the affection. The familial and symmetrical occurrence and the fact that boys are almost exclusively affected, while the similar developmental anomaly in the hip joint of congenital luxation when weight-bearing begins affects mainly girls, point to a congenital disturbance in the normal process of ossification plus some endocrine influence. Demel's