Legg-Calve-Perthes disease

Diagnosis

Your child’s legs may be rotated into various positions during the physical examination to examine range of motion and determine which positions hurt.

Imaging tests

These tests, which are essential for determining the presence of Legg-Calve-Perthes disease, may consist of:

• X-rays. Initial X-rays could appear normal since Legg-Calve-Perthes disease-related abnormalities do not always show up on them for one to two months after symptoms first appear. Your doctor may advise having multiple X-rays taken over time to monitor the disease’s progression.
• Magnetic Resonance Imaging (MRI). This technology creates specific images of the bone and soft tissue inside the body by utilizing radio waves and a strong magnetic field. Although they are not always necessary, MRIs can frequently show Legg-Calve-Perthes disease-related bone deterioration more clearly than X-rays can.

Treatment

The entire process of bone death, fracture, and rebuilding may take several years in Legg-Calve-Perthes disease. The recommended forms of treatment will depend on the disease stage, extend of hip damage, and your age when you first noticed the symptoms.

The femoral head, which serves as the ball of the joint, weakens and fragments as the Legg-Calve-Perthes disease worsens. The socket portion of the joint can act as a mold throughout the healing process to help the broken femoral head maintain its round form.

The femoral head must be securely seated inside the socket for this molding to work. Sometimes, a special leg cast that keeps the legs widely spaced apart for four to six weeks can help this.

Some kids need surgery to help maintain the joint’s ball secure inside its socket. To realign the joint, this technique may entail creating wedge-shaped cuts in the thigh bone or pelvis.

Younger children (under the age of 6) typically don’t require surgery. The hip socket is more naturally malleable in this age group, thus the ball and socket usually continue to fit together effectively without surgery.

Other treatments

Young children in particular may require observation or conservative therapies. Conservative therapies may consist of:

• Activity restrictions. Avoid high-impact activities like running and jumping that could worsen hip deterioration.
• Crutches. Crutches can aid in protecting the joint. Your child might occasionally need to refrain from putting any weight on the hip that is injured.
• Physical therapy. The muscles and ligaments surrounding the hip may shorten as it becomes stiffer. Exercises that stretch the hip can maintain its flexibility.
• Anti-inflammatory medications. To relieve pain, ibuprofen or naproxen sodium may be prescribed by your doctor.