Leg calve perthes disease affects the hip joint in children and occurs when the blood supply to the ball part of the hip joint (the femoral head) is interrupted, causing the bone to die and collapse. In addition to pain, stiffness, and deformity, the condition usually heals on its own, but treatment may be required to prevent long-term consequences.
The exact cause of legg calve perthes disease is unknown, but it may be related to genetic factors, infections, injuries, or environmental factors. Some possible risk factors include:
Age: The condition usually affects children between 4 and 10 years old, but it can occur at any age.
Sex: Boys are four times more likely to develop the condition than girls.
Race: The condition is more common in white children than in black or Asian children.
Family history: Having a parent or sibling with the condition may increase the risk.
Smoking exposure: Being exposed to secondhand smoke may increase the risk.
The symptoms of legg calve perthes disease may vary depending on the stage and severity of the condition. Some common symptoms include:
Pain in the hip, groin, thigh, or knee, especially when walking, running, or climbing stairs.
Limping or difficulty walking.
Reduced range of motion or stiffness in the hip joint.
Leg length discrepancy or uneven growth of the legs.
Muscle wasting or weakness in the affected leg.
To diagnose legg calve perthes disease, a doctor will perform a physical examination and ask about the medical history and symptoms. The doctor may also order some tests, such as:
X-rays: These can show the shape and size of the femoral head and the hip joint, and reveal any signs of bone damage or healing.
MRI: This can provide more detailed images of the soft tissues, such as the cartilage, ligaments, and blood vessels, in the hip joint. It can also show the extent of bone death and regeneration.
Bone scan: This can measure the blood flow and activity of the bone in the hip joint. It can help determine the stage and prognosis of the condition.
The treatment of legg calve perthes disease depends on the age, stage, and symptoms of the child. The main goals of treatment are to:
Relieve pain and inflammation.
Preserve the shape and function of the hip joint.
Prevent or correct any deformity or disability.
The treatment options may include:
Medications: These can include pain relievers, anti-inflammatory drugs, or muscle relaxants to ease the discomfort and swelling in the hip joint.
Physical therapy: This can include exercises, stretches, massage, or heat therapy to improve the strength, flexibility, and mobility of the hip joint. It can also help prevent stiffness and contractures.
Braces or casts: These can help keep the femoral head in the socket and prevent it from collapsing or slipping out. They can also help maintain the range of motion and alignment of the hip joint.
Surgery: This may be needed if the conservative treatments fail to improve the condition or if the hip joint is severely damaged or deformed. The types of surgery may include:
Osteotomy: This involves cutting and reshaping the bones of the hip joint to improve the fit and stability of the femoral head and the socket.
Femoral osteotomy: This involves cutting and rotating the femur (thigh bone) to change the angle and position of the femoral head.
Pelvic osteotomy: This involves cutting and rotating the pelvis (hip bone) to change the shape and size of the socket.
Arthroplasty: This involves replacing the damaged parts of the hip joint with artificial components made of metal, plastic, or ceramic. This is usually reserved for older children or adults who have severe arthritis or disability.
There is no known way to prevent legg calve perthes disease, as the cause is unknown. However, some steps that may help reduce the risk or severity of the condition include:
Avoiding smoking or exposure to secondhand smoke, as this may impair the blood supply to the hip joint.
Seeking medical attention as soon as possible if the child has any symptoms of hip pain, limping, or reduced mobility, as early diagnosis and treatment may improve the outcome and prevent complications.
Following the doctor’s instructions and recommendations regarding the treatment plan, such as taking medications, doing physical therapy, wearing braces or casts, or having surgery, as this may help the hip joint heal faster and better.
Maintaining a healthy weight and lifestyle, as this may help prevent or delay the onset of arthritis or other problems in the hip joint.
