Legg-Calve-Perthes disease
(Redirected from Legg Calve Perthes Disease)
Background
- Avascular necrosis of femoral head
- Capital femoral epiphysis fails to grow because of lack of blood supply
- Affects children 4-9yr old
- Male:female 4:1
- Bilateral in 10%
Clinical Features
- Insidious onset of mild hip pain and limp
- May have painless limp
- May have referred pain to groin, thigh, knee
- Pain often exacerbated by activity, relieved with rest
- Decreased hip abduction and internal rotation
Differential Diagnosis
Pediatric hip pain
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Evaluation
- Plain radiographs of the hip
- May be normal early in disease
- If high suspicion obtain bone scan or MRI
- Imaging findings:
- Widening of cartilage space of affected hip
- Small size ossific nucleus of femoral head
- Subchondral stress fracture line in femoral head
Management
- Orthopedic surgery consultation
- Non-weight bearing
- Protection of hip joint (maintain in abduction and internal rotation)
Disposition
- Generally may be discharged
- Should be done in consultation with orthopedic surgery to ensure appropriate therapy and close follow-up