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Legg-Calvé-Perthes Disease - Coggle Diagram
Legg-Calvé-Perthes Disease
Intro
AVN of capital femoral epiphysis of fem head due to interrupted blood supply
followed by revascularisation + reossification over 18-36mo
M:F = 5:1, mainly 5-10 y/os
Clinical features
insidious onset
limp
hip/knee pain
may initially be mistaken for transient synovitis
bilat in 10-20%
Investigations
x-rays of both hips (incl frog views)
early: increased density of fem head
later: head fragmented + irregular
if initially normal, repeat if sx persist
shows flattening with sclerosis + fragmentation on right, normal on left
bone scan + MRI can be helpful
Tx
if <50% of fem head affected: only bed rest + traction
if severe fem head needs to be covered by acetabulum to act as a mould for the reossifying epiphysis
maintain hip in abduction with plaster/calipers
or perform femoral/pelvic osteotomy
Prognosis
dependent on early dx
usually prognosis good, esp in under 6s
if older, more likely to have fem head deformity + metaphyseal damage, with risk of subsequent degenerative arthritis in adult life
