Legg-Calve-Perthes disease (LCPD) is a rare childhood condition that affects the hip joint.

Also known as Perthes disease, it occurs when blood supply to the femoral head (ball-shaped end of the thigh bone) is interrupted, leading to necrosis (death) of the bone tissue. Over time, the body tries to repair the damage by breaking down, reabsorbing, and regrowing new bone tissue. However, this process can result in permanent deformities, reduced mobility, and arthritis later in life.

Cause and Risk Factors

Although the exact cause of LCPD is unknown, several factors can increase a child’s risk of developing the condition:.

Age: LCPD typically occurs in children aged 4 to 10 years, but can also affect teenagers.
Gender: Boys are affected more often than girls, with a ratio of 4:1.
Family history: LCPD may run in families, indicating a genetic component.
Physical factors: Certain physical characteristics, such as short stature, low body weight, and delayed bone age, may increase the risk of LCPD.
Other conditions: Children with certain medical conditions, such as Down syndrome, hypothyroidism, or cerebral palsy, may have a higher risk of developing LCPD.

Symptoms

The symptoms of LCPD can vary depending on the severity of the disease and the child’s age. Common signs and symptoms may include:.

Limping or favoring one leg, especially after physical activity or periods of rest.
Pain or stiffness in the hip, groin, thigh, or knee area.
Reduced range of motion or flexibility in the hip joint.
Muscle weakness or atrophy (wasting).
Difficulty walking, running, or participating in sports.

In some cases, LCPD may not cause any noticeable symptoms, or the symptoms may be mild and go away on their own. However, untreated LCPD can lead to serious complications and long-term effects, such as:.

Permanent deformity of the hip joint, such as flattening, fragmentation, or collapse of the femoral head.
Chronic pain, stiffness, or limping.
Early onset of arthritis (inflammation and damage to the joint).
Reduced quality of life or psychological distress.

Diagnosis

LCPD can be diagnosed through a combination of physical examination, medical history, and imaging tests. Your child’s doctor may perform the following:.

Physical examination: The doctor will check your child’s hip joint for signs of tenderness, stiffness, or limping, and may ask your child to perform certain movements to assess range of motion and flexibility.
X-ray: An X-ray of the hip joint can reveal abnormalities in the bone structure, such as flattening, fragmentation, or collapse of the femoral head. However, X-rays may not show changes until several weeks or months after the onset of symptoms.
MRI (magnetic resonance imaging): An MRI scan can provide detailed images of the hip joint, including the condition of the bone tissue, blood supply, and surrounding muscles and ligaments. MRI may be used if X-rays do not provide a clear diagnosis or if the doctor suspects complications.

Treatment

The treatment for LCPD depends on the stage of the disease, the severity of symptoms, and the child’s age and health status.

The goal of treatment is to preserve the natural shape and function of the hip joint, prevent further damage, and reduce pain and discomfort.

Some common treatment options for LCPD may include:.

Rest and activity modification: Your child may need to avoid physical activity or sports that involve the hip joint, or use crutches or a wheelchair for a period of time to reduce pressure and stress on the affected area.
Pain management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be recommended to relieve pain or inflammation. In some cases, your child may need stronger medications or injections into the hip joint to manage pain.
Physical therapy: A physical therapist can work with your child to improve range of motion, strength, and flexibility of the hip joint through exercises and stretching, and to reduce muscle wastage or atrophy.
Casting or bracing: Your child may need to wear a cast or brace around the affected leg to immobilize the hip joint and allow it to heal. The cast or brace may be changed or adjusted over several weeks or months as the bone tissue regrows.
Surgery: In some cases, surgery may be necessary to repair or reshape the damaged bone tissue or to realign the hip joint. Surgery may be more effective in younger children who are still growing, as it can guide the growth and development of the hip joint. However, surgery may also have risks and complications, such as infection, bleeding, or nerve damage.

Prevention

There is no known way to prevent LCPD, but some measures may help reduce the risk or severity of the condition:.

Ensure your child maintains a healthy weight and gets enough exercise and nutrition to support bone growth and development.
Encourage your child to participate in physical activities that promote hip joint health and flexibility, such as swimming, yoga, or stretching exercises.
Take your child for regular check-ups and screenings, especially if they have a family history of LCPD or other bone disorders.

Conclusion

Legg-Calve-Perthes disease is a rare but serious condition that can affect children’s hip joint health and mobility. Early diagnosis and treatment are crucial to prevent long-term complications and ensure the best possible outcome.

If you suspect your child may have LCPD, seek medical attention and follow the recommended treatment plan to help them recover and maintain their quality of life.