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Legg-Calvé-Perthes disease is destruction of the growth plate of the thighbone.
Legg-Calvé-Perthes disease develops most commonly in boys between the ages of 5 and 10. It is caused by a poor blood supply to the upper growth plate of the thighbone. The reason for the poor blood supply is not known.
Legg-Calvé-Perthes disease can cause severe hip damage without causing significant symptoms at first. The severe damage may, however, lead to permanent arthritis of the hip. The first symptom is often pain in the hip joint and trouble walking (gait). Pain begins gradually and progresses slowly. The pain tends to worsen when moving the hip or walking. A limp can develop, sometimes before the child experiences much pain. Eventually, joint movement becomes restricted, and the thigh muscles may become wasted (atrophied) from lack of use.
The diagnosis is confirmed by a bone scan or a magnetic resonance imaging (MRI) scan. Later, x-rays may show changes around the growth plate, such as a fracture or destruction of the bone.
Treatment includes prolonged immobilization of the hip. Sometimes the partial immobilization provided by bed rest is sufficient. However, sometimes nearly total immobilization for 12 to 18 months is necessary, requiring traction, slings, plaster casts, or splints. Such treatments keep the legs rotated outward. Physical therapy is used to keep the muscles from contracting and wasting away. If a child is older than 6 and has moderate or severe bone destruction, surgery may be helpful. Regardless of how it is treated, Legg-Calvé-Perthes disease usually takes at least 2 to 3 years to heal. Doctors have recently recently that treatment with bisphosphonates (drugs that help increase bone density]) may reduce the need for surgery.
Last full review/revision February 2008 by Frank Pessler, MD, PhD; David D. Sherry, MD
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