Legg-Calve-Perthes Disease – Symptoms and Causes
Overview
Legg-Calve-Perthes disease affects children when blood flow to the hip’s ball joint (femoral head) stops temporarily. Without blood, this bone tissue dies and begins to break down. The femoral head may lose its round shape as it fragments.
Blood flow eventually returns, starting the healing process. However, if the femoral head doesn’t heal in its proper round shape, it can cause:
- Pain
- Stiffness
- Limited movement
The entire process—from bone death to healing—typically takes several years to complete.
Treatment focuses on keeping the femoral head properly positioned within the hip socket. This is important because the socket acts like a mold, helping the damaged femoral head maintain its round shape while healing.
Doctors use various methods to ensure the joint remains properly aligned throughout this lengthy recovery period.
Signs and Problems
Perthes disease shows several key signs that parents should watch for in their children. The most common indicator is limping, which may develop gradually.
Children might also feel pain or stiffness in the hip, groin, thigh, or knee areas. The hip joint often has limited movement.
Pain typically gets worse when the child is active and feels better during rest periods.
Most children have the condition in just one hip. While both hips can be affected, this usually happens at different times rather than simultaneously.
When To Contact a Healthcare Provider
If you notice your child limping or hear complaints about hip, groin, or knee pain, schedule an appointment with a healthcare provider promptly.
For more serious symptoms like fever or inability to put weight on the leg, seek emergency medical care immediately. These could indicate a more urgent condition that needs quick attention.
Causes
Perthes disease happens when blood flow to the hip joint ball becomes too low for a period of time. This lack of blood supply weakens the bone, causing it to break down.
Medical experts still don’t know exactly why this blood flow reduction occurs. Research continues to look for the specific triggers that lead to this condition.
Risk Factors
Children who get Perthes disease often share certain traits:
- Age: Most children develop this condition between the ages of 4 and 10.
- Gender: Boys face a higher risk, being about four times more likely to develop Perthes than girls.
These factors don’t cause the disease, but they show which children might need closer attention.
Long-Term Complications
Children with Perthes disease face a higher chance of developing hip arthritis as adults. This risk increases when the hip doesn’t heal properly.
Poor healing often means the ball part of the joint doesn’t fit well with the socket, causing early joint wear.
Age at diagnosis plays a key role in outcomes. Children diagnosed after age 6 typically have a higher risk of future hip problems.
Those diagnosed at younger ages have better chances for the hip joint to heal in a normal, round shape.
Risk Factors for Future Complications:
- Diagnosis after age 6
- Poor healing of the ball-and-socket joint
- Irregular joint shape after healing
- Incomplete treatment
The healing quality of the hip joint directly affects long-term function. When the hip heals with an irregular shape, it creates abnormal pressure points during movement. This uneven pressure can damage the joint cartilage over time.
Regular follow-up care helps monitor joint development even after the disease appears to resolve. Doctors may recommend periodic check-ups to track joint health into adolescence and early adulthood.
Some patients may benefit from protective measures to reduce future arthritis risk, including:
- Weight management
- Low-impact exercise
- Avoiding activities that cause hip pain
- Physical therapy to maintain hip strength and flexibility
