What’s Legg Calve Perthes Disease?
The Legg Calve Perthes Disease is a disease in which temporary blood loss occurs to the ball of the hip joint. Due to temporary blood loss, the ball of the hip joint can become fragile and slower to heal. Because of the balls fragility, it can breakdown and become flat, causing a limp and later on develop into osteoarthritis.
The disease occurs in childhood. Though the disease can occur at any age it is more commonly seen in children between the ages of four to eight years old. The disease is five times more common in male children than it is in female children.
An early sign of Legg Calve Perthes Disease is limping with little or no pain. As the disease progresses in children, more symptoms may develop including:
- Hip Stiffness
- Knee Pain
- Lowered Range of Motion
- Upper Leg and Groin Pain
- An Unequal Length of Legs
- Loss of Muscle in the Upper Thigh
The doctor will perform a physical evaluation when a child has symptoms of the disease. The doctor will search for signs limping and loss of motion in the hip. If the disease is suspected, the doctor will usually refer the child to a pediatric orthopedic specialist for a full evaluation.
Test that may be performed to diagnose the disease are x-rays of the hip and pelvis, bone scans, or MRI (magnetic resonance imaging). These tests will not only help in the diagnosis but also show if damage has already occurred to the ball of the hips. Once diagnosed, there are several treatments that the doctor may suggest.
The main purpose of treatments for the disease is to keep the ball in the correct place and to keep the ball round by avoiding damage to the ball. Physical therapy is used to help maintain a wider range of motion. Restricting physical activities such as running may be required for a period of time while the area is healing. The child may be asked to use crutches to keep weight off the affected hip.
Traction devises that gently pull the child’s leg may be used at night. A cast may be needed to keep the area immobile. Sometimes short periods of bed rest may be recommended to help alleviate severe pain. When these treatments aren’t enough, surgery might be necessary.
Surgery for the Disease can vary. One surgery used as part of a treatment plan is a contracture release, a procedure that lengths muscles that may have become shorter due to the immobility induced by a treatment. Another surgery performed is called loose body removal. Loose body removal is a surgery in which a surgeon will remove bone that has broken off the ball or tissue that has been torn in order to restore a better range of motion to the hip joint.
Sometimes a cast can’t maintain a healthy ball and socket placement in the hip. When this occurs, a doctor may recommend hardware implants. Screws, wires or even plates may be implanted in order to correct the ball and socket placement. Another procedure used is joint realignment. Joint realignment will be performed if the ball and socket aren’t proper aligned to each other.
Eventually, blood will again flow to the joint and the joint will heal over two to three years. The prognosis can also vary for each individual that develops Legg Calve Perthes Disease, though it is always better with treatment. Usually, prognosis is better the younger the child is. Generally a child that develops the disease at six years old or younger will have a good chance of healing well and regaining a properly shaped hip joint. Children that are older are more likely not to heal with the correct shape of ball in the hip where the joints are. This means children who develop the disease at an older age are more likely to continue to limp and to develop osteoarthritis at a younger age.
Take a child to the doctor if any of the symptoms occur. Be prepared to answer the doctor’s questions such as when the symptoms began and if any leg position makes the symptoms worse. Also take a list of any medications the child is regularly taking.
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