(LCPD; Osteonecrosis of the Hip—Child; Avascular Necrosis of the Hip—Child; Ischemic Necrosis of the Hip—Child; Coxa Plana; Osteochondritis of the Hip—Child)
by Cynthia M. Johnson, MA
Legg-Calve-Perthes disease (LCPD) is a rare hip disease that affects children. It is a pattern of bone tissue death and repair at the hip which can cause abnormal growth and development in children.
The hip is made of the ball-shaped head of the thigh bone (femoral head) and bowl-shaped socket of the pelvis. LCPD affects the femoral head. There are 4 stages of LCPD:
Severity of LCPD depends on the child's age when the disease started and how much damage was done during fragmentation.
LCPD is caused by an interruption of blood flow to the femoral head. Low or blocked blood flow causes bone tissue death and begins the LCPD cycle. The exact cause of the interruption is not known. Known factors that may lead to loss of blood flow include:
Risk Factors TOP
LCPD is more common in male and at ages 4-8 years. It is also more common in children with European, Asian, or Eskimo ancestry. Other factors that may increase your child’s chance of developing LCPD include:
The primary symptom of LCPD is a limp when walking or running. Other symptoms may include:
You will be asked about your child’s symptoms and medical history. A physical exam will be done. During the exam, your child’s hip will be examined to see how far it can move. The doctor may refer your child to a specialist. An orthopedist focuses on bones and joints.
Images may need to be taken of your child's bones. This can be done with:
Talk with your doctor about the best plan for you. Options include the following:
If your child’s symptoms are mild, your doctor may prescribe physical therapy. A therapist will work with your child to maintain range of motion. You may be taught certain exercises to do with your child at home.
Medical treatment is used to improve healing and prevent further injury to the hip.
In some cases, your child may need surgery.
There are no current guidelines to prevent LCPD because the cause is unknown.
Family Doctor—American Academy of Family Physicians
National Osteonecrosis Foundation
Canadian Orthopaedic Association
When it Hurts to Move—Canadian Orthopaedic Foundation
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Legg-Calve-Perthes disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 5, 2017. Accessed March 20, 2018.
Leet AI, Skaggs DL. Evaluation of the acutely limping child. Am Fam Physician. 2000;61(4):1011-1018.
Perthes disease. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
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Updated May 2015. Accessed March 20, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 1/17/2017
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