Legg-Calvé-Perthes
Disease
Idiopathic avascular necrosis of the proximal femoral epiphysis
Clinical Presentation
Presents between 3 and 12 years of age; peak ages 5-7
4:1 male predominance
Insidious pain and/or limp and activity-related pain
Referred pain to anterolateral thigh or knee
Trendelenburg gait
Decreased hip abduction & internal rotation
Diagnosis
X-ray
May be normal initially
Progression shows joint space
widening, femoral head
flattening
Reproduced with permission from Legg-Calvé-Perthes
disease. Case contributed by Assoc Prof Frank Gaillard.
December 25, 2009. https://radiopaedia.org/cases/legg-calv-perthes-disease-1
Can be detected earlier on bone
scan and MRI
Management
Complications
Premature arthritis
Prognosis depends on:
Nonsurgical
Child's age at onset (younger, better)
Percentage of affected femoral head ’
Observation
NSAIDs
Limited activity
Physical therapy
Casts and bracing
Surgical
Osteotomy
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