Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Legg–Calvé–Perthes syndrome is a degenerative disease of the hip joint, where a add/loss of bone mass leads to some degree of collapse of the hip joint, that is, to deformity of the ball of the femur and the surface of the hip socket. The disease is typically found in young children and small dogs, and it can lead to osteoarthritis in adults. The effects of Perthes can also sometimes continue into adulthood.
It is the idiopathic avascular osteonecrosis of the capital femoral epiphysis of the femoral head. It is caused by an interruption to the blood supply of the head of the femur close to the hip joint.
It is also known as Perthes disease,[1] ischemic necrosis of the hip, coxa plana, osteochondritis and avascular necrosis of the femoral head, or Legg–Perthes Disease or Legg–Calve-Perthes Disease (LCPD).
The direct cause is a reduction in blood flow to the joint. It is thought that the artery of the ligamentum teres femoris closes too early, not allowing time for the medial circumflex femoral artery to take over.[citation needed]Genetics does not appear to be a determining factor, though it may be involved. Some evidence suggests that parental smoking may be a factor, though this is not yet proven, or more recently that a deficiency of some blood factors used to disperse blood clots may lead to blockages in the vessels supplying the joint, but that, too, has not been proven.
Symptoms are hip, knee, or groin pain, exacerbated by hip/leg movement. The pain feels like a tooth ache, possibly severe. There is a reduced range of motion at the hip joint and a painful or antalgic gait. There may be atrophy of thigh muscles from disuse and an inequality of leg length. In some cases, some activity can cause severe irritation or inflammation of the damaged area including standing, walking, running, kneeling, or stooping repeatedly for an extended period of time.
The first signs are complaints of soreness from the child, which are often dismissed as growing pains, and limping or other guarding of the joint, particularly when tired. The pain is usually in the hip, though can also be felt in the knee (so-called ‘referred pain’). In some cases, pain is felt in the unaffected hip and leg.[citation needed] This is due to the child favoring the injured side and placing the majority of the weight on the “good” leg. It is predominantly a disease of boys (4:1 ratio). Whereas Perthes is generally diagnosed between 5 and 12 years of age, it has been diagnosed in children as young as infants. Typically the disease is only seen in one hip, bilateral perthes is seen in about 8-10% of children diagnosed.
X-Rays of the hip joint are absolutely necessary. X-rays will show a small, flattened and fragmented head of femur. A bone scan may be useful in helping determine the extent of the avascular changes. A hip aspiration may be performed if there is suspicion of a septic arthritis.
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