Legg-Calvé-Perthes Disease

OVERVIEW

Legg-Calvé-Perthes disease is a hip disorder that is characterized by ischemic necrosis (avascular necrosis) of the growing femoral head. It can lead to a permanent hip deformity.

This condition is characterized by avascular necrosis of the femoral head (source)
This condition is characterized by avascular necrosis of the femoral head (source)
WHAT CAUSES IT?

This condition is idiopathic however some suspected precipitants include: 

WHAT MAKES US SUSPECT IT?

Risk Factors:

Male sex, ages where epiphyses are most rapidly growing (children ages 4-8)

Initial Presentation:

  • Limp
  • Hip pain
  • Limited hip mobility

History Of Present Illness:

  • Insidious onset
  • A minor trauma is often what marks the start of symptoms
  • Pain is activity related and is relieved by rest.

Musculoskeletal Exam (Physical Exam):

  • Limited hip motion: particularly abduction and medial rotation
CLINICAL WORKUP

X-Ray Imaging: AP and frog-leg lateral positions are useful for margin the diagnosis. The X-ray findings will correlate with the progression and extent of necrosis.

  • Early stages: effusion of the joint, widening of the joint space, periarticular swelling
  • Few weeks: decreased bone density around the joint, collapse of the femoral head present
  • Later stages: replacement of necrotic bone by new bone
 

 

Page Updated: 12.09.2016