Legg-Calve-Perthes Disease

(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)

Definition

Legg-Calve-Perthes disease (LCPD) is a rare hip disease that affects children. It happens when blood supply does not reach the head of the thigh bone (femoral head). This causes bone cells to die.

Normal Hip Anatomy
hip socket

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Causes

It is not known why blood supply does not reach the head of the thigh bone.

Risk Factors

This problem is more common in males and children who are 4 to 8 years of age. It is also more common in children who are White.

Other things that may raise the risk are:

  • Obesity
  • Problems with blood clotting

Symptoms

Limping is a common first symptom. Other problems may be:

  • Hip or groin pain
  • Thigh or knee pain
  • Pain that is worse with activity
  • Limited motion in the hip

Diagnosis

You will be asked about your child’s symptoms and health history. A physical exam will be done. It will focus on the hip. This may be enough to suspect LCPD. Your child may be sent to a doctor who treats bones and joints.

Images of the hip may be taken. This can be done with:

Treatment

Treatment will depend on the child's age. The goal is to ease pain and improve motion. This may be done with:

  • Medicine to ease pain and swelling
  • Physical therapy to improve strength and range of motion
  • Casting and bracing to keep the head of the thigh bone in place

Surgery may be done in children who are not helped by other methods. It will help keep the head of the thigh bone in place.

Prevention

There are no guidelines to prevent LCPD. The cause is not known.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

National Osteonecrosis Foundation
http://nonf.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

When it Hurts to Move—Canadian Orthopaedic Foundation
http://whenithurtstomove.org

REFERENCES:

Legg-Calve-Perthes disease. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/legg-calve-perthes-disease. Accessed September 18, 2020.

Mazloumi SM, Ebrahimzadeh MH, et al. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease. Arch Bone Jt Surg. 2014 Jun;2(2):86-92.

Perthes disease. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00070. Accessed September 18, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 9/18/2020