Description

Legg-Calve-Perthes (LEG-kahl-VAY-PER-salt) is a disease of the childhood condition that occurs when the blood supply to the ball (femoral head) of the hip joint is temporarily interrupted and the bone begins to die.

This bone weakened gradually breaks down and can lose its round shape. The body eventually restores the blood supply to the ball, and the ball is cure. But if the ball is not round after it heals, it can cause pain and stiffness. The entire process of death, bone fracture, and the renewal which can take several years.

To keep the ball in the part of the articulation of the round as possible, doctors use a variety of treatments to keep it tight in the socket portion of the joint. The lace acts as a mold for the fragmentation of the femoral head as it heals.

Symptoms

The symptoms of Perthes disease include:

  • Limping.
  • Pain or stiffness in the hip, groin, thigh or knee.
  • Limited range of motion of the hip joint.
  • Pain that worsens with activity and improves with rest.

Perthes disease usually involves only one hip. Both hips can be affected, but usually are affected at different times.

When to see a doctor

Make an appointment with your health care professional if your child starts to limp or complains of hip, groin or knee pain. If your child has a fever or not you can bear weight on the leg, seek emergency medical attention.

Causes

Perthes disease occurs when there is too little blood reaches the ball portion of the hip joint for a short time. Without enough blood, the bone becomes weak and collapses. The cause of the reduction of the blood flow is unknown.

Risk factors

The risk factors for Perthes disease include:

  • Age. Perthes disease can affect children of almost any age, but is most commonly begins between the ages of 4 and 10.
  • Your child's sex. Perthes is four times more common in boys than in girls.

Complications

Children who have had Perthes disease are at greater risk of developing hip arthritis in adulthood, particularly if the hip joint has a poor healing. If the ball and socket of the joint do not fit well after the healing, the joint may wear out early.

In general, children who are diagnosed with Perthes disease after 6 years of age are more prone to developing hip conditions later in life. The younger the child at the time of diagnosis, the better the possibilities for the articulation of the hip to heal in a typical round shape.

Diagnosis

During the physical exam, your health care professional can move the legs of your child in different positions to check the range of motion and see if any of the positions cause pain.

Imaging tests

These types of tests, which are vital for the diagnosis of Perthes disease, may include:

  • The x-rays. Initial X-rays did not show changes in the hip. It can take 1 to 2 months after the start of the symptoms of the disease-related changes of Perthes to be evident on x-rays. Your healthcare provider will probably recommend several X-rays over time for monitoring the progression of the disease.
  • The magnetic resonance imaging. This technology uses radio waves and a strong magnetic field to make very detailed images of the bones and soft tissues inside the body. Mri can often visualize the bone of the damage caused by the disease Perthes more clearly that the X-rays, but magnetic resonance imaging is not always necessary.

Treatment

In Perthes disease, the healing process may take several years. The type of treatment recommended depends on the:

  • Age when symptoms began.
  • The stage of the disease.
  • Amount of hip damage.

As Perthes disease gets worse, the ball of the joint, called the femoral head, it weakens and breaks into pieces. During healing, the socket part of the joint can serve as a mold. This can help to the weakness of the femoral head to keep its round shape.

For this molding work, the femoral head should sit comfortably within the basin. Sometimes a child uses a special type of plaster in the leg and spreads her legs wide apart for 4 to 6 weeks to keep the bone in the correct position.

Some children need surgery to help keep the ball of the joint is exact within the basin. This procedure may involve decisions wedge-shaped cuts in the femur or pelvis to align the set of new.

Generally, surgery is not necessary for children under the age of 6. In this age group, the socket of the hip is, of course, more moldable, so that the ball and socket often continue to fit well without the need for surgery.

Other treatments

Some children, especially the very young, may need only conservative treatment or observation. Conservative treatments may include:

  • Activity restrictions. Children with Perthes disease should not run, jump, or take part in other activities of high impact that could accelerate the hip damage.
  • Crutches. Sometimes, your child may need to avoid bearing weight on the affected hip. The use of crutches can help to protect the joint.
  • The physical therapy. As the hip is hardened, the muscles and ligaments around, you can shorten. The stretching exercises can help keep the hip joint more flexible.
  • Anti-inflammatory medications. Your health care professional may recommend that babies or children the medicines you can buy without a prescription, such as ibuprofen (Advil, Motrin, others) to help relieve the pain of your child.

Preparing for your appointment

Probably the first time you talk with your child's primary care team about your concerns. After an initial assessment, your child may be referred to a doctor who specializes in diseases of the bones in children, called to a pediatric orthopaedic surgeon.

What you can do

Before your appointment, you can write a list of answers to the following questions:

  • When did these symptoms start?
  • Does a particular position of the leg or of the activity make the pain worse?
  • Do any of your blood relatives, such as father, mother, aunt, or grandfather, have similar symptoms when they were children?
  • Does your child have any other medical problems?
  • What medications or supplements that your child takes regularly?

What to expect from your doctor

Your health care team can do some of the following questions:

  • What are the symptoms of your child?
  • They have gotten worse over time?
  • The symptoms seem to come and go?
  • Is your child active?
  • Has your child had an accident or injury that might be caused by a hip injury?
  • If your child has symptoms, which include pain, where is the pain located?
  • What activity to do that your child's symptoms worse?
  • You rest ease your child's discomfort?
Symptoms and treatment of Legg-Calve-Perthes disease