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Legg-Calvé-Perthes (leg cal-VAY PER-teez) disease, often called Perthes disease, is a problem that changes the hip joint and the way bone grows at the top of the thighbone (femur). It most often happens in one hip, but can affect both.
It may lead to:
Call the doctor right away if your child has a limp and hip pain. Go to the emergency department right away if your child also has a fever. Doctors there can make sure there isn't some other problem, like an infection.
The hip is the joint where the leg meets the body. The top of the thighbone is ball-shaped. It fits inside a round socket. This ball and socket joint lets us move our legs around in all directions.
In Perthes disease, not enough blood reaches the ball of the hip. As a result:
After a few months, the body starts to rebuild the bone. The rebuilt part could be normal, flattened, or enlarged. If the rebuilt ball is not normal, it may not fit well inside the hip socket, causing problems with moving the hip. The changes happen slowly. It usually takes about 2–3 years from the time symptoms start until the bone is finished rebuilding.
Doctors don't know what causes Perthes disease.
Most kids who develop Perthes are between 4 and 10 years old. It happens more often in boys than in girls.
Perthes disease can cause:
These problems may come and go, and usually:
When a child has signs of Perthes disease, the doctor will:
Kids with Perthes disease will have X-rays repeated during care, which can last for several years. In the condition's early stages, bone changes don't always show up on an X-ray. So the doctor may order another test, such as an MRI (magnetic resonance imaging).
A specialist in children's bone problems (a pediatric orthopedist or orthopedic surgeon) most often treats children with Perthes disease. Treatment goals are to:
Treatment may include:
Some children with Perthes disease may need surgery. Sometimes the leg affected by Perthes disease is shorter and may need either a lift in the shoe or, rarely, surgery.
Most children with Perthes disease will heal well and have no long-term problems. The degree of recovery depends on how much of the bone is involved. Kids who have only a small area of bone affected tend to heal the best. Also, younger children tend to heal better than older kids.
A child who has ongoing problems might:
If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-4405.