Legg-Calvé-Perthes (leg cal-VAY PER-teez) disease, often called Perthes
disease, is a problem that changes the hip joint and the way bone
grows at the top of the thighbone (femur). It most often happens in one hip, but can
The hip is the joint where the leg meets the body. The top of the thighbone is
ball-shaped. It fits inside a round socket. This ball and socket joint lets us move
our legs around in all directions.
In Perthes disease, not enough blood reaches the ball of the hip. As a result:
Bone cells in the ball of the hip starve and die.
The body starts to break down the ball of the hip.
After a few months, the body starts to rebuild the bone. The rebuilt part could
be normal, flattened, or enlarged. If the rebuilt ball is not normal, it may not fit
well inside the hip socket, causing problems with moving the hip. The changes happen
slowly. It usually takes about 2–3 years from the time symptoms start until
the bone is finished rebuilding.
What Are the Signs & Symptoms of Legg-Calvé-Perthes Disease?
Perthes disease can cause:
Limping: Often the first sign of Perthes is a limp. Parents might
notice a change in the way their child walks or runs during sports. One hip may seem
stiff or have less movement.
Pain: Most kids have some pain in the hip, groin, thigh, or knee.
These problems may come and go, and usually:
are on one side, but may involve both hips
are worse with activity and get better with rest
What Causes Legg-Calvé-Perthes Disease?
Doctors don't know what causes Perthes disease.
Who Gets Legg-Calvé-Perthes Disease?
Most kids who develop Perthes are between 4 and 10 years old. It happens more often
in boys than in girls.
How Is Legg-Calvé-Perthes Disease Diagnosed?
When a child has signs of Perthes disease, the doctor will:
possibly order blood tests to make sure another problem isn't causing the symptoms
Kids with Perthes disease will have X-rays repeated during care, which can last
for several years. In the condition's early stages, bone changes don't always show
up on an X-ray. So the doctor may order another test, such as an MRI
(magnetic resonance imaging).
How Is Legg-Calvé-Perthes Disease Treated?
A specialist in children's bone problems (a pediatric orthopedist or orthopedic
surgeon) most often treats children with Perthes disease. Treatment goals are to:
help the bones heal so the hip works the best it can. The better the bone heals,
the less chance the hip joint will "wear out" later and develop early arthritis.
Treatment may include:
medicine for pain and inflammation
putting less weight on the hip joint. Kids usually need to stop running and jumping
for a while. Some kids may need to use crutches or a walker for a few weeks or months.
Some children with Perthes disease may need surgery. Sometimes the leg affected
by Perthes disease is shorter and may need either a lift in the shoe or, rarely, surgery.
What Else Should I Know?
Most children with Perthes disease will heal well and have no long-term problems.
The degree of recovery depends on how much of the bone is involved. Kids who have
only a small area of bone affected tend to heal the best. Also, younger children tend
to heal better than older kids.
A child who has ongoing problems might:
need surgery to make the hip work as well as possible and put off the need for
hip replacement surgery
develop hip pain and arthritis as a young adult
need hip replacement surgery at a younger age than most adults who get a replacement
When Should I Call the Doctor?
Call the doctor right away if your child has a limp and hip pain. Go to the emergency department right
away if your child also has a fever.
Doctors there can make sure there isn't some other problem, like an infection.