What is Legg-Calve-Perthes disease?
Legg-Calve-Perthes disease, also called Perthes disease, is
actually not a disease. It is a condition in which there is
temporary decrease in the blood supply to the top of the
thigh bone. The top of the thigh bone is round and fits
into the hip socket to make the hip joint. This condition
usually happens to children between the ages of 4 and 10 and
is more common in boys than girls.
What is the cause?
The blood supply to the thigh bone is interrupted
temporarily. This can cause the bone to die and collapse.
It is not known why the blood supply stops.
What are the symptoms?
The symptoms often start with an achy pain in the hip or
groin area. The pain can also be in the thigh or knee and
will usually stop when your child is resting. Your child
may also limp. Often children will not complain about this
kind of pain at first. It is important to have your child
checked if he or she has any pain or stiffness in the leg,
hip, or knee. It usually happens in just one hip.
How is it diagnosed?
To find the cause of the pain or limp, your child's health
care provider will do an x-ray of the hip. A magnetic
resonance imaging, or MRI, may also be done. An MRI can show
the disease in its earliest stages.
What is the treatment?
Treatment depends on how early the disease is diagnosed and
its severity. The goals of treatment are to:
Make sure the bone stays in the socket while it heals and
the blood supply returns. X-rays will be taken often to
check if the bone is in the right place. Often, a special
cast or brace will be used to get the weight off the thigh
bone and keep the ball of the thigh bone in the hip
socket. If the bone is not kept in place, the top of the
thigh bone may flatten. This can cause arthritis and the
joint not to work properly once the blood supply returns.
Reduce swelling by taking anti-inflammatory medicine.
Repair the joint if needed. Surgery is used to realign
the joint or to repair any damage to the bone or joint.
Restore the range of motion in the joint. This is done by
doing special exercises, traction, or other physical
therapy at the end of the healing process.
Your child's provider will need to see your child often to
check if the top of the thigh bone is starting to get blood
and grow again.
How long does it last?
After 18 to 36 months, the blood supply to the top of the
thigh bone is usually back to normal. Your child may not have
any more problems. Younger children generally have a better
chance of full recovery. In severe cases, osteoarthritis may
develop.
When should I call my child's health care provider?
Call during office hours if:
