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Legg-Calve-Perthes Disease

January 29, 2024

Pedsortho.com Staff

Topics - Developmental

Description, Causes and Treatment of Legg-Calve-Perthes Disease in Children

Legg-Calvé-Perthes disease is a pediatric orthopedic condition affecting the hip. It occurs when blood supply to the round head of the femur (thighbone) is temporarily disrupted, leading to avascular necrosis, where the bone tissue dies due to a lack of blood. Here are key aspects of this condition:

Characteristics

  • Age Group: Typically affects children between the ages of 4 and 8.

  • Gender Prevalence: More common in boys than girls.

  • Unilateral: Usually affects only one hip, but in about 10-15% of cases, it can affect both hips.

Symptoms

  • Hip Pain: Often the first symptom, sometimes accompanied by a limp.

  • Referred Pain: Pain might be felt in other areas like the knee or thigh.

  • Limited Range of Motion: The affected hip may have restricted movement.

  • Limping: A common symptom, especially during physical activities.

Causes

The exact cause of Legg-Calvé-Perthes disease is unknown. Factors such as genetic predisposition, environmental factors, and issues with blood supply to the hip joint are considered potential contributors.

Diagnosis

  • Physical Examination: Assessment of hip mobility and pain.

  • Imaging Tests: X-rays are used to observe changes in the femoral head. MRI may be used for early detection or if the diagnosis is unclear.

Treatment

The goal of treatment is to ensure the femoral head grows normally and fits well in the hip socket. Treatment options depend on the severity of the condition and the child's age:

  • Rest and Limited Weight-Bearing: To reduce joint stress.

  • Physical Therapy: To maintain hip movement and strength.

  • Braces or Casts: To keep the femoral head within the hip socket.

  • Surgery: In severe cases, surgical intervention might be needed to realign the hip.

Prognosis

The prognosis for Legg-Calvé-Perthes disease varies:

  • Younger Children: Generally have a better prognosis as their bones are still growing.

  • Older Children: Might face complications like hip deformity and arthritis.

Most children recover well, but it's important for the condition to be managed carefully to reduce the risk of long-term joint problems. Regular follow-up and treatment adjustments are often necessary throughout the child's growth.

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