Legg-Calve-Perthes Disease
Introduction
Legg-Calve-Perthes disease — also known as ischemic (avascular) necrosis of the hip — is a childhood condition characterized by a temporary loss of blood supply to the ball portion of the hip joint (femoral head). Without adequate blood flow, the femoral head deteriorates. As dying bone cells are replaced with new cells, the bone becomes unstable. The bone may break easily and heal poorly.
Legg-Calve-Perthes disease typically affects one hip, but sometimes it develops in both hips.
Although Legg-Calve-Perthes disease can affect children of nearly any age, it's most common among boys ages 4 to 8. In fact, it's four to five times more common in boys than in girls. When girls develop Legg-Calve-Perthes disease, it tends to be more severe.
The long-term outlook for Legg-Calve-Perthes disease is often good — especially for children who develop the condition very young. The younger the child, the more time there is to reshape the affected hip bone.
Signs and symptoms
Limping is often the earliest sign of Legg-Calve-Perthes disease. Pain or stiffness in the hip, groin or knee is possible as well. For some children, the affected leg becomes shorter.
Causes
The underlying cause of Legg-Calve-Perthes disease isn't clear. In some cases, it may be due to injury or abnormal blood clotting.
Risk factors
Legg-Calve-Perthes disease is most common in Caucasians. The disease may be more likely in physically active children who are small for their age and those who are exposed to secondhand smoke.
Complications
Legg-Calve-Perthes disease may cause a permanently deformed hip joint — especially if the condition develops after ages 6 to 8. Severe cases of Legg-Calve-Perthes disease may increase the risk of osteoarthritis as an adult.
Treatment
If your child is diagnosed with Legg-Calve-Perthes disease, he or she may be referred to a pediatric orthopedic specialist for treatment.
Treatment is designed to protect the hip from further stress and injury and keep the ball of the thighbone in the hip socket. Depending on the severity of the condition, treatment options may include:
- Anti-inflammatory medications. Over-the-counter medications such as ibuprofen (Advil, others) can help relieve pain and reduce joint inflammation. These medications are often recommended for months at a time. The dosage may be decreased as the hip begins to heal.
- Physical therapy. Range of motion exercises can help maintain joint mobility. These exercises can be done at home or with the help of a physical therapist.
- Crutches. Crutches can ease pain by keeping the child's weight off his or her hip.
- Casts, braces or traction. Temporarily immobilizing the bone can help promote healing. This may be done with leg or hip casts, leg braces or traction (applying a pulling force to the bone).
- Surgery. If a groin muscle has shortened due to excessive limping, it may be surgically released from the bone. After surgery, the affected leg is put in a cast for six to eight weeks to allow the muscle to grow to a more normal length. Sometimes the hip ball must be replaced within the socket. In other cases, the hip socket is repositioned.
Legg-Calve-Perthes disease can't be prevented. But with appropriate treatment, most children can return to their normal activities within 18 months to two years.
Informations obtained from National Institute of Health.