Legg-Calve-Perthes disease
Definition
Legg-Calve-Perthes disease is when the ball of the thighbone in the hip doesn't get enough blood, causing the bone to die.
Alternative Names
Coxa plana; Perthes disease
Causes
Legg-Calve-Perthes disease usually occurs in boys 4 - 8 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 will collapse and become 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 - 3 years.
Symptoms
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.
Treatment
The goal of treatment is to keep the ball of the thighbone inside the socket. Your health care provider may call this "containment." Containment is achieved by maintaining a good range of motion of the hip.
Physical therapy and anti-inflammatory medicine (such as ibuprofen) can relieve stiffness in the hip joint. When the hip is painful, or the limp gets worse, restricting activities such as running may help reduce the inflammation. Night-time traction may also help.
Health care providers no longer recommend several months of bedrest.
When these steps fail, surgery may be needed. Surgery ranges from simple lengthening of a groin muscle to major hip surgery to reshape the pelvis. The type of surgery depends on the severity of the problem and the shape of the ball of the hip joint.
Outlook (Prognosis)
The outlook depends on the age of the patient and the severity of the disease. In general, the younger the age when the disease begins, the better the outcome.
Children younger than 6 who receive treatment are more likely to end up with a normal hip joint. Children older than age 6 - 8 are more likely to end up with a deformed hip joint, despite treatment, and may later develop arthritis.
Possible Complications
Osteoarthritis may develop later in life. Early recognition and proper treatment of Legg-Calve-Perthes disease may minimize this complication.
When to Contact a Medical Professional
Call for an appointment with your health care provider if a child develops any symptoms of this disorder.
Review Date:
4/8/2008
Reviewed By:
A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz, Kelli A. Stacy, ELS. Previously reviewed by Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network (12/4/2006).
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