Legg-Calve-Perthes disease is a condition that affects the ball of the femur, or thighbone. The ball is at the top of the femur and fits into the hip socket. This condition cuts off blood supply to the ball, causing the bone to die. This process is called avascular necrosis. The part of the femur affected becomes flat and deformed and is at risk of breaking away from the hip. The cartilage to the ball loses its supporting bone and the ball collapses.
The exact cause of this condition is unknown, but it seems to primarily affect young boys. Early detection and treatment are crucial for preventing complications.
When the blood supply to the ball of the femur diminishes, the ball is at risk of becoming flat and eventually collapsing. Legg-Calve-Perthes disease usually only affects one side of the hip.
Limping is one of the first signs of the condition as the flatness of the ball of the thighbone can make walking difficult. Other symptoms include:
- knee pain
- groin pain
- reduced muscle strength in the thigh
- a decreased range of motion
- shortening of the affected leg
The exact cause of Legg-Calve-Perthes disease is unknown. However, certain risk factors can increase the chances of developing Legg-Calve-Perthes disease. Those with the highest risk:
- are male
- are between the age of 4 and 10
- have a family history of the disease
- are Caucasian
Call your child’s pediatrician or an orthopedic surgeon immediately if you notice symptoms of Legg-Calve-Perthes disease in your child. A physical exam can determine the range of motion within the hip and thigh. However, further testing is necessary to confirm Legg-Calve-Perthes disease. These tests can include bone scans, MRI, and X-rays.
Doctors often use these three imaging tests together to look for damage to the bone and tissues of the affected area. If your doctor diagnoses your child with this condition, they’ll likely order periodic X-rays to monitor the progression of the disease. These images can also help your doctor determine the effectiveness of the treatment.
The treatment for Legg-Calve-Perthes disease depends on the extent of the bone damage. Physical therapy is the preferred course of treatment. Therapy exercises help relieve pain and decrease the chances of further damage to the bone. According to the Mayo Clinic, children under 6 years respond best to physical therapy because their conditions generally aren’t as extensive.
Physical therapy methods may include:
- stretching to increase flexibility
- exercising to improve strength
- using temporary leg casts
- using crutches
- getting short-term bed rest for severe pain
Your child’s doctor may recommend surgery if the damage to your child’s femur doesn’t improve. The older your child is, the more likely it is they’ll need surgery. There are several types of surgery that can help improve Legg-Calve-Perthes disease. Some procedures involve removing particles that restrict joint movement. Other surgeries involve molding entire portions of the femur. Your child’s surgeon can also move the hip and femur to improve their alignment.
Home care used along with medical treatment can be helpful. Light stretches can improve pain in the hip and leg, and your child may also use heat pads or ice packs. Your child’s doctor might recommend over-the-counter pain relievers like ibuprofen to relieve discomfort.
Exercise is important for your child’s recovery and overall well-being. However, your doctor may recommend that they refrain from high-intensity workouts. Exercises that include running and jumping generally aren’t recommended because they can put added stress on the hip and thighs.
Your child might experience long-term effects of the disease if the femoral bone is damaged. For example, a deformed head of the femoral bone may not fit exactly into the ball joint of the hip, leading to possible pain and arthritis.
However, early intervention will help treat Legg-Calve-Perthes disease and can also minimize the effects of future joint conditions in the hip. According to the American Academy of Orthopaedic Surgeons, the general outlook for most children with Legg-Calve-Perthes disease is good. Within two years of treatment, most children recover and return to normal activities.