Legg-Calve-Perthes disease (LCPD) is a disorder of the upper part
of the thighbone (head of the femur) that causes breakdown of the head of the
femur. This is followed by new bone formation.
LCPD develops because of loss of blood flow to the head of the
femur. This causes breakdown (avascular necrosis) and deformity of the femur
where it connects with the hip socket. The bone reforms in the hip area when
the blood supply returns to normal. During this time, the femur is soft and may
easily fracture and collapse. The head of the femur heals in an abnormal shape
and does not fit properly into the hip socket, causing stiffness and pain.
The cause of LCPD is unknown. It occurs most often in
children ages 3 to 12. Boys are affected about 4 to 5 times as
often as girls. Usually only one hip is affected, although it is possible to
have LCPD in both hips.
Symptoms include pain, limping or an uneven gait, decreased
movement, loss of height, and loss of muscle mass in the thigh. Treatment
depends on the severity of symptoms but may include physical therapy, a brace
or cast, or surgery. Occasionally the disease heals on its own without
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
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