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What Is Legg-Calvé-Perthes Disease?

Legg-Calvé-Perthes disease (also known as Perthes) is a condition in which the blood supply to the hip bone is temporarily interrupted, causing the bone and cartilage in the hip to deteriorate. Gradually, the weakened bone and cartilage are removed by the child’s body and it is replaced by new bone growth. This process typically occurs over a period of two years or more, but depends on the age of the child.

Perthes disease affects the hip joints; it does not develop in other joints.

What Causes Perthes Disease?

The cause of Perthes is unknown. The condition usually occurs in children from 4 to 8, but can occur between ages 2 to 14.

The disease often develops in children who are very physically active.  In most children, the condition typically occurs in one of their hips, and only approximately 10 – 15% of children have both of their hips affected.

Perthes is rare, affecting roughly 5.5 of 100,000 children per year. The condition affects boys three to five times more than girls.

Perthes Disease Symptoms and Effects

If your child has Perthes, their symptoms may include:

  • Pain in any of the following areas: groin, hip, inner thigh, or knee.
  • Limping  perhaps without a known cause or injury
  • Limited  hip range of motion.

Perthes Disease Treatment and Diagnosis

As leaders in pediatric orthopedics, skilled orthopaedic surgeons at Gillette Children’s Specialty Healthcare are experts in diagnosing and treating Perthes.

An orthopaedic surgeon may perform a physical exam and use common radiology services like X-ray, advanced MRI or an arthrogram to diagnose Perthes disease.  An arthrography is a specialty type of X-ray used to evaluate the surface of the hip bone. An arthrography differs from a standard X-ray because a special dye is injected into the hip joint to produce a more detailed image.

Depending on your child’s age, the severity of the condition, and the family’s preference, orthopedic surgeons may recommend  any combination of the following treatments for Perthes, including:

Non-surgical options:

  • Observation – especially for children 5 years or younger
  • Pain management including non-steroidal anti-inflammatory drugs.
  • Limiting physical activity levels to prevent further damage to an already weakened bone.
  • Physical therapy exercises to maintain hip range of motion.
  • Bracing or casting may be used to place the hip bone in an ideal position to promote healing of the hip back into a ball-like shape.    

Surgical options:

  • Surgery may be performed to reposition the damaged, ball-like portion of the hip joint. This repositioning uses the hip socket to mold the healing hip to take on a spherical shape during recovery.  

Once your child’s hip has healed completely, the disease is unlikely to return. Gillette orthopedic surgeons continually see and monitor progress children with Perthes until they stop growing and reach skeletal maturity. 

The main goals of Perthes disease treatment are:

  • Keeping your child as comfortable as possible and managing their pain.
  • Maintaining adequate range of motion of the hip.
  • Keeping the ball of the hip within the hip socket during the healing process, to maximize molding of the hip into a ball-like shape

Integrated Care

At Gillette, you’ll benefit from the in-depth knowledge of one of the country’s largest groups of pediatric orthopedic specialists. The family-centered environment at Gillette will help your child successfully heal and prevent damage to the hip bone.

An integrated team will help you navigate the services you need and often, your family will see a team of specialists during a single visit to one location. For Perthes disease, treatment might include working with experts in:

ADD Child Life and Therapeutic Recreation