Legg-Calvé Perthes disease is a condition that damages the hip in children and can cause pain and limitation of movement. Although rare, it has a significant impact on the quality of life of affected children and their families. Next, we will stop to explain what Perthes disease is and its treatment, as well as its main symptoms and causes of this disease.
What is Legg-Calvé Perthes disease?
Legg-Calvé Perthes disease consists of the cessation of blood flow to the head of the femur, which produces necrosis of this part of the bone.
Eventually the body will restore blood delivery, although this process usually takes several years. If the head of the femur has lost its spherical shape It can leave consequences such as stiffness in the hip joint and pain.
Symptoms of Perthes disease
The symptoms of Perthes disease may coincide with other conditions such as hip dysplasia, so it is important to consult with a trusted professional to carry out a correct diagnosis. Usually, but not always, symptoms occur only on one side of the hip. The most common are the following:
- Limping: it is one of the first symptoms, along with pain.
- Pain: it can be experienced in the hip, thigh or knee.
- Limitation of range of motion.
- Loss of muscle mass.
- Shortening of a leg.
Who is affected by Perthes disease?
The Perthes disease primarily affects children between four and eight years of age, although it can occur from the age of two to adolescence. It is four times more common in boys than in girls and usually occurs in Caucasian people.
Stages of the Legg-Calvé Perthes
It is a disorder in which four different stages are distinguished:
- Necrosis: The blood supply to the head of the femur fails, so it breaks down and loses its shape. Characteristic symptoms of this stage include hip pain and limping. In the x-rays you can already see that the bone has lost its shape.
- Fragmentation: Necrotic tissue is crushed or fragmented, and the body replaces the dead cells with new ones. Limitation of movement is added to the previous symptoms.
- Reossification: Bone tissue forms again, and symptoms improve.
- Remodeling: The body tries to restore the original shape of the head of the femur. It is the recovery phase although, very often, the head of the femur does not regain its spherical shape, which has consequences for the patient.
The entire process, from necrosis to remodeling, takes several years to complete, so it is important to go to health services when you notice the first symptoms.
Causes of Perthes disease
The main reason for this disorder is the cessation of blood supply to the head of the femur, although it is not known with certainty why this occurs. The causes of Perthes disease are unknown.. Both genetic and environmental factors have been studied, but the results have been inconclusive.
How is Perthes disease diagnosed?
When symptoms appear, the health professional can perform the following tests:
- Complete physical examination: the health professional will look for loss of hip mobility and characteristic lameness.
- X-rays: in order to observe both the change in bone shape and the loss of density.
- In some cases, an MRI or bone scan may be helpful to find out the stage of the disease and the amount of tissue affected.
The younger the child is at the time of diagnosis, the better the prognosis for recovery; It is important to go as soon as possible to a orthopedic doctor if the child limps or complains of pain in the hip, thigh or knee.
Receiving the diagnosis of a childhood illness can be overwhelming for the entire family, it is a good idea to educate yourself, connect with other patients or search foundations or support groups for Perthes disease in order to accompany the little ones in the best way.
Risk factors for Legg-Calvé Perthes disease
Although the exact causes of the disease are unknown, some risk factors have been observed that can increase the probability of suffering from it.
- Age: it usually occurs in children between 4 and 8 years old, although cases occur in children and adolescents of almost any age.
- Sex: it is four times more common in boys than in girls.
- Race: most cases occur in Caucasian people, being very unlikely in African Americans.
Treatment of Perthes disease
The treatment to follow will depend on the stage of the disease, the severity of the condition and the age of the patient. The objective will be to maintain the spherical shape of the head of the femur, as well as its correct position.
The process may include:
- Rest: especially in the early stages, to avoid putting weight on the affected hip. The child should especially avoid high-impact activities such as running or jumping.
- Physiotherapy: with the aim of maintaining hip mobility and fighting against the stiffness caused by the disease. The use of braces such as crutches may be recommended.
- Surgery: In some cases, surgery may be necessary to maintain the correct position of the head of the femur within the hip socket.
How long does Perthes disease last?
From the time the disease is diagnosed to recovery it can take more than 18 months, and often more than two years. Correct repair of the joint is important to minimize the risk of future complications and sequelae.
Complications after suffering from Perthes disease
Children who have had Perthes disease are at greater risk of developing hip conditions as adults, such as arthritis. To reduce this risk, early diagnosis and adequate treatment in the hands of professional traumatologists to restore the rounded shape of the head of the femur.
Legg Calvé Perthes disease is a rare condition of the hip joint that occurs in childhood. With timely diagnosis and treatment, most patients can recover completely, although in some cases the consequences remain long-term. Therefore, it is important to pay attention to the symptoms and go to a doctor. hip specialist traumatologist to help us with the diagnosis and correct treatment of the disease.
At Elgeadi Traumatology we have a team of top-level professionals to accompany patients from diagnosis to full recovery. You can request an appointment in any of our network of medical centers in Madrid.
4 thoughts on “¿Qué es la Enfermedad de Legg-Calvé Perthes? Conoce sus síntomas y tratamientos”
Hello
When I was little I had pains and now from Mallorca I have a lot of hip pain and they told me that my bone is oval instead of round.
I have also been informed that the only cure is hip replacement, and both hips are deformed. I would like to know more.
Hello Cristina,
Thank you very much for sharing your case. In situations like yours, it's essential that a specialist evaluate your imaging studies and current condition to determine the degree of involvement and assess whether a hip replacement is the best option or if there are other alternatives.
We offer video consultations where our specialists can review your case in detail and advise you on the best treatment options. If you wish, you can schedule an appointment, and we will be happy to help you.
Greetings.
Hello, good evening. I've had Perthes disease since I was four years old. The doctors couldn't tell my parents what was wrong with me. They told them I had flat feet, and I had to wear orthopedic boots for quite some time. After many tests, they finally reached a conclusion. I had several bone grafts, but they didn't work. In the end, I had to have a hip replacement. Today, I have a hip prosthesis and I'm working, but I'm in pain. And not only that. It has also complicated other problems with my neck and back. I can't live a normal life because my wife has to help me bathe from the waist down, and also help me put on my shoes, socks, etc. My leg is giving way, and I have hardly any muscle mass. Is this normal? Because from what I read, they say that after getting a prosthesis, you get better. But in my case, I'm getting worse, and I'm already 50 years old.
Hi Sergio, it's not "normal" to worsen after a prosthesis: with a history of Perthes disease, there may be leg length discrepancy, weakness, lumbar degeneration, or trochanteric problems that maintain pain and dysfunction. A complete orthopedic evaluation (X-rays, stability assessment, and infection check) is recommended to adjust the treatment.