Also known as Legg-Perthes Disease and Legg-Calve-Perthes disease (LCPD).
It is the idiopathic osteonecrosis of the capital femoral epiphysis of the femoral head. The goal of treatment is to avoid severe degenerative arthritis.
In more normal terms, it is caused by an interruption to the blood supply of the head of the femur close to the hip joint.
Incidence:
Caucasians are affected more frequently than other races, males are affected 4-5 times more often than females and it is most commonly seen in persons aged 3-12 years, with a median of 7 years of age. In the US, 1 in 1200 children younger than 15 years will have this disease.
Symptoms are hip or groin pain, exacerbated by hip/leg movement. There is a reduced range of motion at the hip joint and a painful gait. There may be atrophy of thigh muscles from disuse and an inequality of leg length.
Investigations:
X-Rays are absolutely necessary. A bone scan may be performed. A hip aspiration may be performed if a septic joint is suspected.
Treatment involves bedrest to take weight off the joint. It may require traction, leg braces, a plaster cast and physiotherapy. Surgery is only rarely necessary.
Orthopedic assessment is crucial. Younger children have a better prognosis than older children.
There are no drugs for treatment of Perthes'. Analgesic medication should be given as necessary.