Legg-Calve-Perthes disease is a childhood hip disorder that is initiated by an interruption of blood flow to the ball of the femur that is known as the femoral head.
Legg-Calve-Perthes disease is also known as LCP or Perthes disease. Because of the absence of blood flow the bone dies (osteonecrosis or avascular necrosis) and ceases to grow. Over a period of time healing occurs when new blood vessels infiltrate the bone and remove the necrotic bone which causes loss of bone mass and a weakening of the femoral head. This loss of bone mass causes the head of the thigh bone to collapse and the area to become inflamed and irritated.
This condition is rare and usually occurs in children aged 4 to 10 years and is experienced more often among boys than girls. As LCP runs its course the body absorbs dead bone cells and replaces them with new ones and reshapes the head of the thigh bone resulting in a deformation that can lead to arthritis later in life. Legg-Calve-Perthes disease typically occurs in only one hip but bilateral Perthes happens in about ten percent of children diagnosed.
Patients with Legg-Calve-Parthese Disease may experience hip, knee, or groin pain that is made worse by hip or leg movement; reduced range of motion, appearance of an intermittent limp (abductor lurch) with mild pain, and the quadriceps muscles and their adjacent thigh soft tissues may atrophy.
Legg-Calve-Perthes disease is caused by low blood flow to the femoral head, or the ball portion of the hip joint. Low blood flow means the bone will become unstable and injure easily. It also means healing may take longer and/or may heal improperly. The underlying cause of low blood flow to this area of the body is still unknown, but a number of factors have been correlated to the condition.
Age is one major indicator. Although children of any age can contract the condition, it mostly affects children between the ages of four and eight. Girls are five times less likely to suffer from Legg-Calve-Perthes disease than boys. Additionally, race plays a factor with white children more likely to contract the illness than black children. There isn’t significant data on Legg-Calve-Perthes disease presenting in other races to make further determinations.
Finally, there have been cases in which Legg-Calve-Perthes disease has affected several individuals within the same family.
Basic treatments usually include removing mechanical pressure from the joint until the disease has run its course. Options include using traction (separating the femur from the pelvis to reduce wear), or braces (for at least an eighteen month period) in order to restore range of motion, and surgical intervention when there is permanent joint damage.
Doctors have issued a few recommendations intended to prevent the onset of Legg-Calve-Perthes disease, including daily exposure to the sun. Studies indicate 15 minutes exposure to the face and hands per day is enough to supply the body with sufficient vitamin D. The extra dose of vitamin D will promote the production of calcium in the body, which, in turn, will strengthen bones.
Additionally, doctors recommend a healthy diet and caution against allowing children to become underweight. This may lead to weaker, more fragile bones. Parents are warned against high protein diets, as this may increase the body’s need for additional sources of calcium.
In cases where the child is underweight or has weak bones, extra care should be taken to prevent falls at home and outdoors. Children already diagnosed with Legg-Calve-Perthes disease should be taken to a doctor at the first sign of pain or injury, following a fall.