Legg-Calvé-Perthes Disease: Symptoms, Causes & Treatment

Perthes disease (Legg-Calvé-Perthes disease) is a disorder affecting the hip joint in children, usually between ages four and ten, and affects boys more than girls. It occurs when blood flow to the head of the femur (the upper ball part of the thigh bone that fits into the hip socket) is temporarily cut off or reduced, so the lack of blood supply causes part of the bone tissue to die.

The disease then passes through stages over months to years: the damaged bone breaks down, then the body gradually rebuilds it with new bone. The problem is that during this period of weakness the head of the femur is soft and deformable if subjected to great pressure, and may lose its regular round shape, which affects joint movement later. Its most prominent symptoms in the child are a limp (altered gait) and pain in the hip or thigh, and the pain is often in the knee (referred pain) so it is misunderstood, with limited hip movement.

The main goal of treating Perthes disease is to keep the head of the femur stable inside the hip socket and as round as possible during the rebuilding period, so it grows healthy. Treatment depends on the child's age, the severity, and the stage: it includes monitoring and restricting strenuous activities, physiotherapy to preserve the joint's range of motion, pain relievers, and sometimes braces or surgery to keep the bone head in its correct position in more severe cases. Many children, especially younger ones, recover with good results. Early detection when a limp or hip or knee pain appears is important to protect the joint long-term.

• A limp (altered gait) that may be painless at first.
• Pain in the hip or thigh, often in the knee (referred pain).
• Limited hip movement and stiffness.
• Pain worsening with activity and improving with rest.

• A temporary cutoff of blood flow to the head of the femur.
• The exact cause of the blood-supply disruption is unknown.
• It affects children (usually 4-10 years) and boys more.

• Clinical examination of the hip, its range of motion, and the gait.
• Hip X-ray to assess the femoral head and the disease stage.
• MRI in early or unclear stages.

Preserving the joint (the main goal)

• Monitoring and restricting strenuous activities to protect the soft bone head.
• Physiotherapy to preserve the joint's range of motion.

Interventions

• Pain relievers and sometimes braces to keep the bone head in the hip socket.
• Surgery in more severe cases or in older children to preserve the joint shape.

This content is educational and does not replace consulting a pediatric orthopedic specialist.

• Deformity of the femoral head and loss of its round shape.
• Limited hip movement and early joint arthritis in the future.
• Leg-length difference in some cases.

• There is no prevention of the disease, but early detection and treatment protect the joint shape.
• Not neglecting a limp or hip or knee pain in a child.
• Adhering to the treatment plan and follow-up throughout the rebuilding period.