Decrease (-) Restore Default Increase (+)
Bookmark and Share

Related Information

 

Legg-Calve-Perthes disease

Definition

Legg-Calve-Perthes disease occurs when the ball of the thighbone in the hip does not get enough blood, causing the bone to die.

Alternative Names

Coxa plana; Perthes disease

Causes

Legg-Calve-Perthes disease usually occurs in boys 4 through 10 years old. There are many theories about the cause of this disease, but little is actually known.

Without enough blood to the area, the bone dies. The ball of the hip collapses and becomes flat. Usually only one hip is affected, although it can occur on both sides.

The blood supply returns over several months, bringing in new bone cells. The new cells gradually replace the dead bone over 2 to 3 years.

Symptoms

The first symptom is often limping, which is usually painless. Sometimes there may be mild pain that comes and goes.

Other symptoms may include:

Exams and Tests

During a physical examination, the health care provider will look for a loss in hip motion and a typical limp. A hip x-ray or pelvis x-ray may show signs of Legg-Calve-Perthes disease. An MRI scan may be needed.

Treatment

The goal of treatment is to keep the ball of the thigh bone inside the socket. The health care provider may call this containment. The reason for doing this is to make sure the hip continues to have good range of motion.

The treatment plan may involve:

  • A short period of bed rest to help with severe pain
  • Limiting the amount of weight placed on the leg by restricting activities such as running
  • Physical therapy to help keep the leg and hip muscles strong
  • Taking anti-inflammatory medicine, such as ibuprofen, to relieve stiffness in the hip joint
  • Wearing a cast of brace to help with containment
  • Using crutches or a walker

Surgery may be needed if other treatments do not work. Surgery ranges from lengthening a groin muscle to major hip surgery, called an osteotomy, to reshape the pelvis. The exact type of surgery depends on the severity of the problem and the shape of the ball of the hip joint.

It is important for the child to have regular follow-up with the doctor and an orthopaedic specialist.

Outlook (Prognosis)

Outlook depends on the child's age and the severity of the disease.

Children younger than 6 years old who receive treatment are more likely to end up with a normal hip joint. Children older than age 6 are more likely to end up with a deformed hip joint, despite treatment, and may later develop arthritis.

When to Contact a Medical Professional

Call for an appointment with your health care provider if a child develops any symptoms of this disorder.

References

Canale ST. Osteochondrosis or epiphysitis and other miscellaneous affections. In: Canale ST, Beaty JH, eds. Campbell’s Operative Orthopaedics. Philadelphia, Pa: Elsevier Mosby; 2012:chap 32.

Sankar WN, Horn BD, Wells L, Dormans JP. Legg-Calve-Perthes disease. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 670.3.


Review Date: 8/22/2013
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
 

Medical Care

Cancer
Pregnancy & Prenatal Classes
Weight Loss
Orthopedics
Heart Disease
Neurology
Women's Health
More Medical Care

Locations

Hospitals
Immediate Care
Health Centers
Emergency Room
Doctors Offices
Specialists
Affiliate Hospitals

Patients and Visitors

MyChart
Pay Your Bill
Request an Appointment
Get Healthy
Support Groups
Fitness Groups
Mobile Applications
Clinical Trials
Online Nursery
Classes and Events
Send an eCard
Patient Stories
Places to Stay

About Us

Quality Report 
Careers
Ways to Help
Community Outreach
Contact Us
(502) 629-1234

Connect with us

© 2014 Norton Healthcare
Serving Kentucky and Southern Indiana