What Is Legg-Calve-Perthes Disease?
Legg-Calve-Perthes disease is a condition that affects the ball of the femur (thighbone). The ball is at the top of the femur and fits into the hip socket. In this condition, blood supply to the ball is cut off and the bone dies. That portion of the femur becomes flat and is at risk of breaking away from the hip.
The exact cause of this condition is unknown, although it seems to primarily affect young boys. Early detection and treatment is crucial in preventing further complications of the disease.
Legg-Calve-Perthes disease usually only affects one side of the hip.
Risk Factors of Legg-Calve-Perthes Disease
The exact cause of Legg-Calve-Perthes disease is unknown. However, certain risk factors can increase the chances of developing Legg-Calve-Perthes disease. These are:
- being male
- being between 4 and 10
- having a family history of the disease
- being Caucasian
Symptoms of Legg-Calve-Perthes Disease
When the blood supply to the ball of the femur is diminished, the ball is at risk of becoming flat and eventually collapsing. 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
- decreased range of motion
- shortening of the affected leg
Diagnosis of Legg-Calve-Perthes Disease
Call your pediatrician immediately if you notice symptoms of Legg-Calve-Perthes in your child. A physical exam can determine the range of motion within the hip and thigh. However, further testing is required to confirm Legg-Calve Perthes, incuding:
These three imaging tests are often used together to help your doctor see the damage within the bone and tissues of the affected area. Once your doctor makes a diagnosis, he or she will likely order periodic X-rays to monitor the progression of the disease. Such images can also be used to determine the effectiveness of treatment.
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 within the bone. According to the Mayo Clinic, children under 7 years respond best to physical therapy because their conditions generally aren’t as extensive. (Mayo Clinic , 2012).
Physical therapy methods may include:
- stretches to increase flexibility
- exercises to improve strength
- temporary leg casts
- use of crutches
- short-term bed rest for severe pain
Your doctor may recommend surgery if the damage to your child’s femur doesn’t improve. The older your child is, the more likely he or she will need surgery. There are several types of surgery that can help improve Legg-Calve-Perthes disease. Some procedures remove particles that restrict joint movement, while other surgeries mold entire portions of the femur. The hip and femur may also be moved so they are better aligned.
Home care may be used in conjunction with medical treatment. Light stretches can improve pain within the hip and leg, and your child may also use heat pads or ice packs. Your 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 have him or her 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.
According to the National Institutes of Health, new bone cells generate in the femur within two to three years (NIH , 2011). Osteoarthritis, a joint condition, may develop in the affected joint later in life.
However, early intervention will help treat Legg-Calve-Perthes disease and can also minimize the effects of future joint conditions in the hip. The chances of a full recovery are greater in children age 6.