Legg-Calve-Perthes disease


By Joseph M. Harris, PT, ATC, CEAS - President/Clinical Director - Physical Therapy Solutions, PSC



Legg-Calve-Perthes disease is a condition of the hip occurring in children. It is much more common in boys. There appears to be some increased risk with exposure to secondhand smoke.

This condition occurs when the blood flow to the femoral portion of the hip joint is decreased causing the bone to break easily and become unstable. The child may complain of hip pain that causes a limp. The hip joint will become stiffer and less mobile. The affected leg may become shorter. When the child rests, the pain may diminish or go away, only to return with resumption of activity.

The cause is unknown, and it typically occurs in children between the ages of 2 and 12. It appears to be more likely in physically active boys who are small for their age. There is a higher prevalence in Eskimos, Asians, and Caucasians.

The younger children are when they develop the disease, the better their outcome. At the beginning of the disease process, the femoral head becomes denser with possible fracture of the supporting bone. Then bone begins to fragment and reabsorb. Bone then rebuilds and reshapes as it heals. The disease can cause hip deformity and increased chance of osteoarthritis.

Treatment will be focused on resting the ball portion of the hip joint and improving hip strength and range of motion. The goal of treatment will also be to reduce hip irritation, to keep the ball from collapsing, and to regain the spherical shape of the femoral head. Treatment options include anti-inflammatory medications to help with pain, physical therapy to improve strength and range of motion, use of crutches to keep the weight off of the hip, or immobilization of the hip may be done with a brace or cast. Depending on how the disease progresses, surgery may be indicated.

60 to 70 percent of children with Legg-Calve-Perthes disease do well with no long-term disability. The disease usually takes two to three years to heal. There are no known preventative measures.

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By Joseph M. Harris, PT, ATC, CEAS

President/Clinical Director

Physical Therapy Solutions, PSC

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