Legg-Calve-Perthes Disease (Hip Joint Problem)

What is Legg-Calve-Perthes disease?

Legg-Calve-Perthes disease, also called Perthes disease, is a problem with the hip joint in children. It usually happens to children between the ages of 4 and 10 and is more common in boys than girls. It usually happens in just one hip.

What is the cause?

This problem happens when the round end of the thighbone gets soft. This is caused by a temporary lack of blood flow to that part of the bone. The end of the bone may become flat or deformed. It may no longer fit properly in the hip socket. The thighbone may become shorter than the other thighbone. Doctors don’t know why the blood stops flowing to this area or what causes blood flow to start up again.

What are the symptoms?

The symptoms often start with an ache in the hip or groin area. The pain can also be in the thigh or knee. It usually goes away when your child is resting. Your child may have some stiffness and may limp.

How is it diagnosed?

Legg-Calve-Perthes disease is diagnosed with one or more of the following scans:

• X-ray of the hip
• ultrasound, which uses sound waves and their echoes passed through the body from a small device held against the skin to create pictures of the leg
• MRI, which uses a strong magnetic field and radio waves to take pictures from different angles to show thin cross sections of the leg

How is it treated?

Treatment depends on how early the disease is found and how severe it is. The goals of treatment are to:

• Make sure the bone stays in the hip socket until the blood supply returns. X-rays will be taken often to see if the bone is in the right place. Often, a cast or brace will be used to get the weight off the thighbone and keep the end of the thighbone in the hip socket. If the bone is not kept in the right position, your child could get arthritis in the joint, and the joint may not work properly when blood starts flowing to this area again.
• Reduce swelling with anti-inflammatory medicine.
• Repair the joint if needed. Surgery may be done to realign the joint or repair damage to the bone or joint.
• Restore the range of motion in the joint. This is done with exercises, traction, or other physical therapy as blood flow comes back to the bone.

Your healthcare provider will need to see your child often to see if the top of the thighbone is getting more blood and growing again.

After 18 to 36 months, blood flow to the top of the thighbone is usually back to normal. Your child may not have any more problems. Younger children generally have a better chance of full recovery.

How can I take care of my child?

Follow the treatment plan.

Ask your healthcare provider:

• how and when you will hear your child’s test results
• how long it will take your child to recover from this illness
• what activities your child should avoid and when your child can return to normal activities
• how to take care of your child at home
• what symptoms or problems you should watch for and what to do if your child has them

Make sure you know when you should bring your child back for a checkup.