Legg-Calve-Perthes Disease

Signs and Symptoms

Legg-Calve-Perthes Disease (LCPD) is a deterioration of the top of the thighbone (femur) due to insufficient blood supply. We don't know what causes LCPD, but doctors think it may be related to growth hormones. It can strike children throughout the growing years. Boys get it four times as often as girls. It is more common in children ages 4 to 8, and those who are small for their age. Without treatment, your child may lose the ability to rotate his or her hip, thereby worsening a limp.

Although knee pain may be the only initial symptom, persistent thigh or groin pain as well as a decrease in the size of the muscles in the upper thigh also can occur. Addition indications of the disease may include:

• Slight shortening of the leg or legs to unequal length, which is called asymmetry
• Hip stiffness restricting movement in the hip
• Difficulty walking or a limp with walking

Diagnosis

Your doctor may flex and rotate your child's hips to check for pain. X-rays and possibly magnetic resonance imaging (MRI) may be used to check whether your child's bone marrow is failing and to see how much the head of the femur may have collapsed.

Treatment

After the head of the thighbone collapses, it may grow again. Your doctor may put on a cast or brace to keep your child's leg in position and use X-rays to chart the new growth. The goal of treatment is for the head of the thighbone to maintain a normal shape while it matures and to keep it covered by the socket. The growth process takes many months.

In some cases, surgery is required. In order to "contain" the head of the thighbone in the rounded surface of the acetabulum (the socket or bone that receives the head of the femur), surgery may be performed to change the alignment of the femur or pelvis.