Legg-Calve-Perthes is a serious disease that affects children between 5- and 10-years-old, according to "The Merck Manual for Healthcare Professionals." It also seems to affect boys more than girls. The disease involves damage to the bone at the hip. The damage slowly develops and, though most children will not have any pain, they usually walk with a limp.
What is Legg-Calve-Perthes?
Children with this disease have what is referred to as avascular necrosis of the femoral head. The femur is the thigh bone and the head of the femur bone is at the hip. Avascular necrosis means the death of tissue, or necrosis, because it is not getting enough blood supply. The actual cause is not yet known, but physicians do know that it takes several months for the problem to develop, according to Current Diagnosis & Treatment in Orthopedics.
Development of Disease
Necrotic areas slowly develop. After some time, new blood vessels will form in some of those areas. Current Diagnosis & Treatment in Orthopedics explains that specialized bone cells, called osteoclasts, will then remove some of the dead bone. Another type of specialized bone cells, called osteoblasts, will form new bone on top of some of the dead areas. The head of the femur is now weak and parts of it can collapse.
Symptoms
Children do not have any symptoms at first. Eventually, they will start to walk with a limp, but most do not have any pain. For those children who do experience pain, it is usually mild. The pain will start at the hip and travel down the thigh as far as the knee. The thigh muscle on the same side of the disease will be wasting away and the children will not be able to move their hip in every direction.
Treatment
Those who are younger than 5-years-old and those children with little diseased tissue do not need any treatment. This is because their femoral head is still mainly made of cartilage and not bone. Physicians do not treat those older than 5 if they can easily move their hips. Children who do get treatment require casts and braces. Some physicians prefer to perform surgery.
Prognosis
The prognosis, or outcome, for children with Legg-Calve-Perthes disease is excellent, according to Current Diagnosis & Treatment: Pediatrics.The outcome, however, depends on how much damage has been done, how deformed the bone has become while it was still soft and how much bone is involved in the disease. Children who develop this disease at a later age seem to have a worse prognosis.
References
- "Current Diagnosis & Treatment in Orthopedics"; Harry Skinner, M.D., Ph.D.; 2006
- "Current Diagnosis & Treatment: Pediatrics"; William Hay, Jr., M.D., Myron Levin, M.D., Judith Sondheimer, M.D., Robin Deterding, M.D.; 2009
- Merck Manual for Healthcare Professionals: Osteochondroses
