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Legg-Calve-Perthes disease

Definition


Disease: Legg-Calve-Perthes disease Legg-Calve-Perthes disease
Category: Bones, joints, muscles diseases

Disease Definition:

Legg-Calve-Perthes disease is a childhood condition that is associated with a temporary loss of blood supply to part of the hip joint. A process could occur without adequate blood flow, in which the bone becomes unstable, breaks easily and heals poorly.

 

Even though this condition could sometimes occur in both hips, but it usually affects only one hip. This disease is most common among boys between the ages of 4 and 8, but it could affect children of nearly any age.

 

Usually, the best outcomes are in children who develop this disease when they're very young, because the younger the child is, the more time there is to reshape the affected hipbone. However, in the long run, most children with Legg-Calve-Perthes disease do quite well.
 

Work Group:


Symptoms, Causes

Symptoms:

Some of the signs and symptoms of Legg-Calve-Perthes disease may include:

 

  • Limited range of motion
  • Limping
  • In some children, shortened leg on the affected side
  • Pain or stiffness in the hip, knee, thigh or groin

 

The pain and stiffness in some cases could get better when the child is resting, but whenever he/she becomes active, the pain reappears.
 

Causes:

What exactly causes Legg-Calve-Perthes disease, which is also known as ischemic (avascular) necrosis of the hip, is still not known.

 

In this disease, there's a temporary loss of blood supply to the ball portion of the hip joint (femoral head), which causes the femoral head to deteriorate. The bone will become unstable as the dying bone cells are replaced with new cells, which makes the bone break easily and heal poorly.

 

Legg-Calve-Perthes disease is most common in whites. Even though this disease is about five times more common in boys than in girls, but when it occurs in girls, it tends to be more severe. This disease usually occurs in children who are exposed to secondhand smoke, and those who are small for their age and physically active.
 

Complications

Complications:

Some of the complications that could occur due to this disease may include:

Increased chance of osteoarthritis:

A child's risk of osteoarthritis as an adult will be increased in case he/she has a severe case of Legg-Calve-Perthes disease.

Permanent hip deformity:

This disease, especially if it appears after ages 6 to 8, could cause a permanently deformed hip joint.
 

Treatments:

A child may be referred to a pediatric orthopedic specialist for treatment in case he/she has been diagnosed with Legg-Calve-Perthes disease.

 

Protecting the hip from further stress and injury and keeping the ball of the thighbone in the hip socket is what treatment for this disease will aim at. Resting the joint could help, however, prolonged bed rest isn't recommended.

 

Treatment will depend on the severity of the condition. Some options may include:

Physical therapy:

To help maintain joint mobility, the child could perform range-of-motion exercises. These exercises could be done either with the help of a physical therapist, or at home.

Anti-inflammatory medications:

To help relieve pain, some over-the-counter medications could be used, such as ibuprofen. When these medications are used for months at a time, they could also reduce joint inflammation. As the child's hip begins to heal, the dosage could be decreased. Acetylsalicylic acid isn't recommended for use in children, despite the fact that it's an anti-inflammatory medication.

Casts, braces or traction:

Leg or hip casts, leg braces or traction, which is applying a pulling force to the bone, could temporarily immobilize the bone to promote healing.

Crutches:

By keeping the child's weight off his/her hip, crutches could ease pain.

Surgery:

A groin muscle could be surgically released from the bone in case it has shortened due to excessive limping. The affected leg will be put in a cast for six to eight weeks after the surgery, allowing the muscle to grow to a more normal length. In some cases, the hip socket could be repositioned, while in other cases, the hip ball could be replaced within the socket.

 

There is no way to prevent Legg-Calve-Perthes disease. However, most children could go back to normal activities within 18 months to 2 years in case they receive appropriate treatment.
 

Prognosis:

Not available

Expert's opinion

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