...less medical jargon in a 'Quick Glance' format!
Legg-Calve-Perthes Disease is a temporary condition in children in which the ball-shaped head of the thigh bone, referred to as the femoral head, loses its blood supply. As a result, the femoral head collapses. The body will absorb the dead bone cells and replace them with new bone cells. The new bone cells will eventually reshape the femoral head of the thigh bone. It disease causes the hip joint to become painful and stiff for a period of time.
Legg-Calve-Perthes disease goes through four phases of changes that affect the head of the femur. The phases include:
Phase 1 -
Blood supply is absent to the femoral head and the hip joint becomes inflamed, stiff, and painful. Portions of the bone turn into dead tissue. The ball of the thigh bone becomes less round in appearance on x-rays. This phase can last from several months up to one year.
Phase 2 -
The body cleans up the dead bone cells and replaces them with new, healthier bone cells. The femoral head begins to remodel into a round shape again. The joint is still irritated and painful. This phase can last from one to three years.
Phase 3 -
The femoral head continues to model itself back into a round shape with new bone. This phase lasts for one to three years.
Phase 4 -
Normal bone cells replace the new bone cells. This last phase can last a few years to complete the healing process. Symptoms:
Knee pain which may be the only initial symptom
Persistent thigh or groin pain
Wasting of muscles in the upper thigh
Apparent shortening of the leg, or legs of unequal length
Hip stiffness that restricts movement in the hip
Difficulty walking, walking with a limp
Limited range of motion
Causes:
The cause of Legg-Calve-Perthes disease is unknown. It is four times more likely to occur in boys than girls.
This disease commonly affects first-born children and is typically seen in children 4 to 8 years of age. The majority of cases affect only one hip.
Treatment:
Specific treatment will be determined by your child's physician based on:
your child's age, overall health, and medical history
the extent of the condition
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
The goal of treatment is to preserve the roundness of the femoral head and to prevent deformity while the condition runs its course. Treatment options are dependent upon the amount of hip pain, stiffness, and x-ray changes over time, as well as how much of the femoral head has collapsed.
Typically, the first step of treatment is to regain hip motion and eliminate pain that results from the tight muscles around the hip and the inflammation inside the joint. Treatment may include:
rest
activity restrictions
medications
bed rest and traction
casting or bracing to hold the femoral head in the hip socket, permit limited joint movement, and allow the femur to remold itself into a round shape again
surgery to hold the femoral head in the hip socket
physical therapy to keep the hip muscles strong and to promote hip movement
