All You Want To Know About Perthes Disease

All You Want To Know About Perthes Disease

What is Perthes Disease?

Perthes disease (also known as Legg–Calvé–Perthes disease (LCPD) or Legg– Perthes disease) is a childhood hip disorder initiated by a disruption of blood flow to the head of the femur. Due to the lack of blood flow, the bone dies (osteonecrosis or avascular necrosis) and stops growing.

The weakened bone gradually breaks apart and can lose its round shape. The body eventually restores blood supply to the ball, and the ball heals. But if the ball is no longer round after it heals, it can cause pain and stiffness. The complete process of bone death, fracture and renewal can take several years.

Symptoms Signs and symptoms of Legg-Calve-Perthes disease include: 1. Limping 2. Pain or stiffness in the hip, groin, thigh or knee 3. Limited range of motion of the hip joint

Causes Legg-Calve-Perthes disease occurs when too little blood is supplied to the ball portion of the hip joint (femoral head). Without an adequate blood supply, this bone becomes unstable, and it may break easily and heal poorly.

Risk factors Risk factors for Legg-Calve-Perthes disease include: 1. Age. Although Legg-Calve-Perthes disease can affect children of nearly any age, it most commonly begins between ages 4 and 8.

2. Your child's sex. Legg-Calve-Perthes is up to five times more common in boys than in girls.

3. Race. White children are more likely to develop the disorder than are black children.

4. Genetic mutations. In a small number of cases, Legg-Calve-Perthes disease appears to be linked to mutations in certain genes.

Complications Children who have had Legg-Calve-Perthes disease are at higher risk of developing hip arthritis in adulthood — particularly if the hip joint heals in an abnormal shape. If the hip bones don't fit together well after healing, the joint can wear out early.

Diagnosis During the physical exam, your doctor may move your child's legs into various positions to check range of motion and see if any of the positions cause pain.

Imaging tests These types of tests are vital to the diagnosis of Legg-Calve-Perthes disease and may include:

X-rays Initial X-rays may look normal because it can take one to two months after symptoms begin for the changes associated with Legg-Calve-Perthes disease to become evident on X-rays. Your doctor will likely recommend several X-rays over time, to track the progression of the disease.

Magnetic Resonance Imaging (MRI) This technology uses radio waves and a strong magnetic field to produce very detailed images of bone and soft tissue inside the body. MRIs often can visualize bone damage caused by Legg-Calve-Perthes disease more clearly than X-rays can, but are not always necessary.

Bone scan In this test, a small amount of radioactive material is injected into a vein. The material is attracted to areas where bone is breaking down and rebuilding, so these areas show up on the resulting scan images. This test can reveal evidence of Legg-Calve-Perthes disease earlier than X-rays can, but MRIs have largely replaced bone scans for this diagnosis.

Treatment In Legg-Calve-Perthes disease, the complete process of bone death, fracture and renewal can take several years. The types of treatment recommended will depend on the: 1.

Age when symptoms began

2.

Stage of the disease

3.

Amount of hip damage

Other Treatments Some children, particularly very young ones, may need only conservative treatments or even no treatment at all. Conservative treatments may include: 1. Activity restrictions. Running and jumping might accelerate hip damage.

2. Crutches. In some cases, your child may need to avoid bearing weight on the affected hip. Using crutches can help protect the joint.

3. Physical therapy. As the hip stiffens, the muscles and ligaments around it may shorten. Stretching exercises can help keep the hip more flexible.

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