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Epiphyseal collapse, particularly of the lateral part of the epiphysis (referred to as the “lateral pillar”) is another feature of LCPD that is of prognostic significance. The more the lateral pillar has collapsed, the poorer is the prognosis . Treatment planning based on the extent of epiphyseal collapse outlined by Herring has been popular but its value is limited by the fact that the extent of collapse of the lateral pillar can only be determined in Stage IIb. Waiting until stage 2b to apply the Herring grading and then planning treatment especially in the older child is fraught with the risk of intervening too late, thereby missing the opportunity of preventing the femoral head from getting deformed. The sequence of events described here is not seen if the onset of LCPD is in adolescence . Adolescent LCPD has a very poor prognosis as collapse of the epiphysis occurs early, rrevascularization and repair is often incomplete and permanent deformation is exceedingly common