Legg–Calvé–Perthes disease

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Legg–Calvé–Perthes disease
X-ray of Legg–Calvé–Perthes disease
Synonyms	Perthes disease, Legg–Perthes disease, Calvé–Perthes disease
Pronounce	N/A
Specialty	Orthopedic surgery
Symptoms	Hip pain, limping, limited range of motion
Complications	N/A
Onset	Typically between ages 4 and 10
Duration	Several years
Types	N/A
Causes	Unknown
Risks	Male gender, Caucasian ethnicity, family history
Diagnosis	X-ray, MRI
Differential diagnosis	Transient synovitis, Slipped capital femoral epiphysis, Juvenile idiopathic arthritis
Prevention	N/A
Treatment	Physical therapy, bracing, surgery
Medication	N/A
Prognosis	Generally good with treatment
Frequency	1 in 1,200 children
Deaths	N/A

Legg–Calvé–Perthes disease (LCPD) is a childhood hip disorder initiated by a disruption of blood flow to the femoral head. Due to the lack of blood flow, the bone begins to die, a process known as avascular necrosis. The disease is named after three physicians: Arthur Legg, Jacques Calvé, and Georg Perthes, who independently described the condition in the early 20th century.

Signs and Symptoms

The primary symptom of Legg–Calvé–Perthes disease is a limp, often accompanied by pain in the hip, thigh, or knee. The pain may be intermittent and can worsen with activity. Other symptoms include stiffness and limited range of motion in the affected hip.

Causes

The exact cause of Legg–Calvé–Perthes disease is unknown. However, it is believed to be related to a temporary reduction in blood flow to the femoral head. Factors such as genetic predisposition, trauma, and coagulation abnormalities may contribute to the development of the disease.

Diagnosis

Diagnosis of Legg–Calvé–Perthes disease typically involves a combination of physical examination, patient history, and imaging studies. X-rays are commonly used to assess the condition of the femoral head. In some cases, magnetic resonance imaging (MRI) or bone scans may be necessary to provide a more detailed view of the hip joint.

Treatment

Treatment for Legg–Calvé–Perthes disease aims to relieve pain, maintain hip motion, and ensure proper healing of the femoral head. Options include:

• Non-surgical treatments: These may include rest, activity modification, physical therapy, and the use of anti-inflammatory medications. In some cases, braces or casts may be used to keep the femoral head in the correct position.
• Surgical treatments: Surgery may be recommended in severe cases or when non-surgical treatments are ineffective. Procedures can include osteotomy, which involves cutting and realigning the bone, or other techniques to improve the shape and function of the hip joint.

Prognosis

The prognosis for children with Legg–Calvé–Perthes disease varies. Many children recover fully with appropriate treatment, although some may experience long-term complications such as hip deformity or osteoarthritis in adulthood. Early diagnosis and treatment are crucial for improving outcomes.

See also

• Avascular necrosis
• Femoral head
• Osteoarthritis
• Orthopedic surgery
• Pediatric orthopedics

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