What is it?
Legg-Calve-Perthes (pronounced leg-cal-VAY-PER-teez) disease is a bone disease that affects the top of the long leg bone inside the hip socket (in medical terms, the capital femoral epiphysis). The blood supply to the bone gets interrupted, and the bone tissue dies and collapses. The bone breaks across the top. The blood supply will come back and the bone regrow, but sometimes there are long-term problems.
Who gets it?
Legg-Calve-Perthes disease primarily affects children ages 3-12 years, boys 4-5 times more than girls. It can also affect older youth and adults. Whites are affected more often than African-Americans or Asians. It is not hereditary; in fact, the cause of the disease is not known. One in 12,000 children younger than 15 years old is affected.
How is it diagnosed?
The first clues that a boy has Legg-Calve-Perthes disease are pain in his thigh or knee and a stiff hip on the affected side. (In about 15-20% of cases, both hips are affected.) It's painful for the boy to move his leg to the side. The thigh muscles on the affected side are smaller than the healthy side. When both legs are compared, the affected leg looks shorter because of the breakdown of the bone in the hip. X-rays will show the broken bone at the top of the leg. There are four different systems for classifying how bad the disease is, but physicians do not agree on which is the best system to use.
How is it treated?
In some cases, especially in children under 6 years old, treatment consists of bed rest, stretching exercises, and frequent check-ups. Some children with Legg-Calve-Perthes will need a brace or cast to keep the affected hip from moving around. This allows the leg bone to grow back in the right shape (round at the top). In severe cases, surgery is needed to fix deformity in the hip and make the top of the leg bone have a round shape.
The older the child when the disease starts, the more problem he will have with it, and the greater the chance that he'll have arthritis in that hip. Whatever treatment is used, the child will need to have x-rays taken every 3-4 months. It takes 2-3 years for the leg bone to fully heal.
Information for this article was taken from:
- Legg Calve Perthes Disease. Wheeless' Textbook of Orthopaedics.
- Nochimson, G. (2001). Legg-Calve-Perthes Disease. eMedicine, accessed at http://www.emedicine.com/emerg/topic294.htm
