Legg-Calve-Perthes Disease

Wikis > Paediatrics > Osteochondroses > Legg-Calve-Perthes Disease

Legg-Calve-Perthes Disease/Perthe’s Disease/ Osteochondrosis of the Femoral Capital Epiphysis

Aseptic necrosis/osteochondroses of neck and proximal epiphysis of femur – femoral head becomes flattened. Most commonly ages 2 – 12 (usually 4-9). M>F. More common than 1 in 1000 children.

Cause unknown. Associated with changes in vascular supply and venous drainage; coagulation abnormalities have been demonstrated; children tend to be shorter; higher proportion of children with ADHD develop it (? role of trauma).

Characterised by ischaemic necrosis, collapse and subsequent repair. 85% present with limp and hip/groin pain. 15% have referred pain to knee – probably from obturator nerve involvement. Usually unilateral (up to 8% bilateral). Have some limitation of rotation and abduction (flexion usually normal) – may have atrophy of thigh muscles.

Usually resolves in 2-3 years- with rest, avoidance of aggravating activities, brace to maintain abduction and internal rotation  all aimed to reduce force on hip ( frustration of child in not able to participate in sport & other activities).

Physiotherapy for restoration and maintenance of movement.

Rarely need surgery (eg proximal femoral varus osteotomy)

Better prognosis in younger child. Increased risk for long term osteoarthritis.

Related Topics:
Transient Synovitis of the Hip

Other Osteochondroses:
Buschke disease | Calcaneal Apophysitis | Diaz (Mouchet’s) Disease | Distal Tibial Epiphysitis | Freiberg's Disease | Iselins Disease | Kohler's Disease | Legg-Calve-Perthes Disease | Osgood-Schlatter Disease | Osteochondrosis of Os navicularis | Severs Disease | Thiemann’s Disease | Treves’ or Ilfeld’s Disease

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