Gage sign

Last revised by Daniel J Bell on 2 Aug 2021

The Gage sign is a V-shaped lucent defect at the lateral portion of the epiphysis and/or adjacent metaphysis. It is pathognomonic for Legg-Calve-Perthes disease.

It may occur early in the disease and is one of the five indicators of a worse prognosis, which are:

  • Gage sign
  • calcification lateral to the epiphysis
  • lateral subluxation of the femoral head
  • horizontal growth plate
  • metaphyseal cyst

History and etymology

The sign was described by H Courtney Gage (1886-1947) a British radiologist, in an article in 1933 3; he was Director of Radiology at St Mary's Hospital in London 4.

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