UMEM Educational Pearls

Title: Legg Calve Perthes Disease

Category: Orthopedics

Keywords: Hip, pediatrics, arthritis (PubMed Search)

Posted: 7/9/2017 by Brian Corwell, MD
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Idiopathic osteonecrosis of the femoral head

Children as young as 2 or as old as 12 but generally 4 to 8 (worse in older children)

Fare better than adults with osteonecrosis of femoral head

1 in 10,000

4-5x more common in males, much less common ini African Americans

Unilateral femoral head involvement 90% of the time (Bilateral 10% of the time)

Long term consequences are deformity and arthritis

Typical presentation: Subacute limping for weeks (Painless)

As activity worsens limp, it is maximal at the end of the day (Intermittent)

As in adults with hip pathology, IF pain is reported, it is located at the upper anterior thigh and groin

On examination, look for restriction in range of motion of the hip (compare with contralateral side)

May only present with mild to moderate decreased range of motion of the hip

30 versus 60 degrees for example

ABduct both legs with pelvis in neutral OR Place one hand on contralateral pelvis and ABduct affected leg with other hand.