Legg-Calvé-Perthes Disease (LCPD)
Legg-Calvé-Perthes disease is one of the most important hip joint disorders in children. It occurs as a result of a temporary reduction in blood supply to the head of the femur, leading to gradual breakdown of the bone, followed by reformation over a prolonged period that may last months to years.
Early diagnosis and careful follow-up are essential to prevent permanent deformity of the hip joint.
Case Definition
Condition Overview
Perthes disease occurs when blood flow to the femoral head is temporarily reduced, leading to temporary weakening of the bone followed by changes in its shape.
It most commonly affects children between the ages of 4 and 10 and is more frequent in boys.
Symptoms That Require Parental Attention
• Pain in the hip or knee joint.
• Limping or an abnormal walking pattern without a clear cause.
• Limited hip joint movement, especially when moving the leg outward.
• Mild stiffness in the morning or after physical activity.
• Pain after playing or running.
• In some cases, an obvious limp without pain.
Causes of Perthes Disease
The exact cause is still unknown, but possible contributing factors include:
• Temporary reduction in blood supply to the femoral head.
• Mild genetic factors.
• Delayed bone growth in some children.
• High physical activity in certain age groups.
• Poor development of blood vessels supplying the joint.
How Is It Diagnosed?
• Clinical examination to assess gait and range of motion.
• X-rays of the pelvis to determine disease stage and bone damage.
• MRI in early stages before X-ray changes appear.
• Assessment of leg length discrepancy.
Stages of Perthes Disease
1. Ischemic stage: reduced blood supply.
2. Fragmentation stage: breakdown of the femoral head.
3. Re-ossification stage: new bone formation.
4. Healing stage: final bone shape restoration.
Early diagnosis leads to better outcomes.
Treatment Options
Conservative Treatment (Most Common):
• Physical therapy to improve hip mobility.
• Flexibility exercises to prevent stiffness.
• Pain relievers when needed.
• Activity modification to reduce joint stress.
• Braces or special devices in selected cases.
Surgical Treatment:
Surgery may be considered when:
• Diagnosis occurs after age 8 with severe changes.
• Significant loss of joint motion.
• Severe femoral head collapse.
• Failure of conservative treatment.
The goal is to improve femoral head coverage during bone healing.
Prognosis and Recovery Duration
• The condition may take 1–3 years to complete all stages.
• Younger children usually have better outcomes.
• Regular follow-up is essential to prevent deformity or leg length difference.
Advice for Parents
• Do not ignore any limp, even if mild.
• Encourage swimming and cycling instead of running and jumping.
• Commit to physical therapy sessions.
• Maintain regular imaging follow-up.
• Seek medical advice if pain or limping worsens.
Frequently Asked Questions About Perthes Disease
We fully understand the importance of having all the necessary information to make informed decisions about your health. Therefore, we have compiled the most frequently asked questions about Perthes disease in children and provided clear and reliable answers. We hope this section helps you gain a better understanding of the condition.
Yes, in many cases the shape of the hip joint returns to normal if early intervention is provided.
A mild deformity may occur if the diagnosis is delayed or if the condition is not treated properly.
Yes, but only after selecting appropriate activities and avoiding running or high-impact jumping.
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