Legg-Calvé-Perthes disease (or Perthes disease) is a temporary condition in children in which the ball-shaped head of the thigh bone, referred to as the femoral head, loses its blood supply. As a result, the femoral head collapses. The body will absorb the dead bone cells and replace them with new bone cells. The new bone cells will eventually reshape the femoral head of the thigh bone. Legg-Calvé-Perthes disease causes the hip joint to become painful and stiff for a period of time.
Legg-Calvé-Perthes disease goes through four phases of changes that affect the head of the femur. The phases include:
The cause of Legg-Calvé-Perthes disease is unknown. It is five times more likely to occur in boys than girls.
Legg-Calvé-Perthes disease commonly affects first-born children and is typically seen in children 4 to 10 years of age. The majority of cases affect only one hip.
The child typically complains of pain in his/her hip that is aggravated by activity. Sometimes, they will also experience pain in their thigh or knee area. The child usually walks with a limp and reports that rest will alleviate the pain.
The symptoms of Legg-Calvé-Perthes disease may resemble other conditions or medical problems of the hip. Always consult your child's physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for Legg-Calvé-Perthes disease may include:
Specific treatment for Legg-Calvé-Perthes disease will be determined by your child's physician based on:
The goal of treatment is to preserve the roundness of the femoral head and to prevent deformity while the condition runs its course. Treatment options are dependent upon the amount of hip pain, stiffness, and x-ray changes over time, as well as how much of the femoral head has collapsed.
Typically, the first step of treatment is to regain hip motion and eliminate pain that results from the tight muscles around the hip and the inflammation inside the joint. Treatment may include:
The ultimate goal in Legg-Calvé-Perthes disease is to diagnose the condition early in order to allow as much time as possible to let the femoral head remodel back into a round shape. Other treatment goals include controlling pain, maintaining hip motion, and preventing continued hip deformity.
The two most critical factors that determine the outcome are the child's age and how much of the femoral head is affected by this condition.
The more severe the case, the greater the likelihood that the child may experience limited hip motion, differences in leg lengths, and further hip problems in adulthood.