Legg-Calvé-Perthes
Think twice before diagnosing “Recurrent Transient Synovitis” or “Hip Strain” - Sean M. Fox MD
image by: Perthes Kids Foundation
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Remember Where You Started
For all the new and current warriors battling Perthes, here are some tips:
- Always follow your instinct. It will not lead you in the wrong direction. If it feels right, then God is leading you down the correct path.
- Ask for your medical records, and if they do not give them to you, go to the person higher in the chain of command. Those are YOUR records and you can learn a lot that your physician will never tell you in person (like a cut was made too deep and caused your son’s hip to fracture – not to mention the bone was too soft).
- Do not attempt a head splitting osteotomy until the bone is hard enough to handle…
Resources
Legg Calve Perthes Disease
The limping child often grabs our attention and makes us ponder many conditions, like Toddler’s Fracture, Septic Arthritis, SCFE, Osteomyelitis, and Growing Pains. One additional condition that shouldn’t be overlooked is one with an interesting name: Legg Calve Perthes Disease.
Legg Calve Perthes Disease vs Slipped Capital Femoral Epiphysis
Legg Calve Perthes Disease (LCPD) A rare vascular femoral condition in children that affects the hip, this occurs when the blood supply to the rounded head of the femur(thigh bone) is temporarily disrupted causing vascular necrosis, a process in which bone cells die from lack of adequate blood supply. Slipped Capital Femoral Epiphysis (SCFE) is a condition that primarily affects adolescents during their growth spurt. It involves the displacement of the ball at the upper end of the thigh bone (femur) from the hip joint.
Limping Child? Think LIMPSS
Legg-Calvé-Perthes disease (LCPD) is a progressive idiopathic avascular necrosis of the femoral head. It’s typically seen in children aged 3 to 12 years, boys more than girls (4:1), and whites more than blacks (10:1).2 Although the classic presentation of LCPD is unilateral pain with difficulty internally rotating and abducting the hip, up to 1 in 6 children with LCPD will lose the lottery twice in 1 play, and it’ll occur bilaterally.3 Although diagnosis is classically made on radiograph of the hips, just remember to get the “frog leg lateral” to get the best views!
All You Need to Know About Legg-Calvé-Perthes Disease
The symptoms of LCPD may come and go over several months or years, depending on the healing process of the bone. The symptoms may also be more noticeable during cold or humid weather or during periods of growth spurts. It is usual for symptoms to vary from child to child, depending on their age, activity level, and individual response.
Ancient Skeleton Yields Earliest Diagnosis Of Legg-Calvé-Perthes Disease In China
Some time between the 5th and 3rd centuries BC, a young man was buried in a simple cemetery in Shaanxi Province, China. His mushroom-shaped hip, though, is far from common -- it gives us the first diagnosed case of Legg-Calvé-Perthes disease in all of China.
Is there a better way to catch Legg-Calvé-Perthes disease in children?
The childhood disease typically strikes in kids between 4 and 10, and this young age limits the tools doctors can use to detect damage early, before bone cells die and cause permanent damage. MRI is the best technology available to diagnose LCPD, but the scans have limited ability to diagnose and predict clinical outcomes before the disease causes severe tissue damage.
Pearl of the Day: Legg-Calvé-Perthes Disease
Legg-Calvé-Perthes Disease Background - hip disorder that occurs between ages 2 - 13 (mostly ages 4 - 9) - avascular necrosis or osteochondrosis in femoral head - repeated episodes of ischemia leading to infarction and necrosis - reossification and remodeling occur over 2 - 4 years -> femoral head collapses -> increased risk of subluxation.
Racial and Geographic Factors in the Incidence of Legg-Calvé-Perthes’ Disease: A Systematic Review
Legg-Calvé-Perthes’ disease (Perthes’ disease) is an idiopathic osteonecrosis of the developing femoral head. The underlying mechanism of disease and the disease determinants are unknown. It occurs 5 times more commonly in boys than in girls. Within the United Kingdom, it typically arises between the ages of 4 and 8 years, although presentation occurs later in India
Remember Where You Started
Seven braces, six shoe lifts, five sets of crutches, four reclining wheelchairs (sizes XS, S, M, L) three walkers, two canes, and one wheelchair ramp – this represents six years of surgeries and dealing with Perthes for more than nine years (2.5 years were misdiagnosed)...For all the new and current warriors battling Perthes, here are some tips...
Core EM
Pain usually mild/absent in the early stages, but often located in hip/groin region as disease progression occurs. Some patients may only experience distal medial thigh pain (”referred pain”) with respect to articular branches of the obturator nerve.
Life in the Fastlane
LCPD develops as a result of proximal femoral epiphysis ischaemia of unknown aetiology; aka avascular necrosis (AVN) of the proximal femoral head. The disease is usually insidious in onset and may occur after an injury to the hip. It is most common in male children aged 4-10 years, unilateral in 90% of cases. In cases which are bilateral, the joints are involved successively, not simultaneously.
Perthes Kids Foundation
Perthes Kids Foundation was established to help raise global awareness for children and families surviving Legg-Calve-Perthes Disease, a degenerative hip bone disorder (osteochondritis) that makes it painful to walk.
Perthes NZ
Mum of two perthes kids, having also had perthes as a child, I am interested in helping others to avoid the pitfalls and find the joy that does come with seeing your child grow and mature, with an empathy and maturity that only a journey like perthes can bring.
Perthes Warrior's
My name is Jodie, my son Brady was diagnosed with Perthes disease a few months ago. We are wanting to get a local support group started & spread awareness
A Child's Journey with Perthes Disease
There are successes and normal lives to be had after Perthes - though during the long and tedious process (years!) and the uncertainty that comes with it, its easy to question if things will ever be normal again.
A Hip For Donavan
Donavan's control battle with Perthes disease (LCPD).
Christopher's Journey
One boy's journey to recovery.
Dalton's Journey
Dalton was diagnosed with Legg Calve Perthes Disease (LCPD) on 12/27/08 at age 4.
Tanner's Legg Calve Perthes Journey
What a wild ride it is...
National Osteonecrosis Foundation
Legg-Calvé-Perthes disease is a rare disease of the hip that afflicts approximately 1 in 1200 children. Of those children, only about one in four are girls.
StatPearls
Legg-Calve-Perthes disease usually occurs between the ages of 3 to 12 years old, with the highest rate of occurrence at 5 to 7 years. It affects 1 in 1200 children under the age of 15. Legg-Calve-Perthes disease occurs most commonly in male patients, with a male to female ratio between 4:1 and 5:1. It is bilateral in 10% to 20% of affected cases.
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