Legg-Calve-Perthes Disease

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:

• Pain is increasing
• Your child is having greater problems with mobility
• You have questions or concerns.