(LCPD; Osteonecrosis of the Hip; Avascular Necrosis; Ischemic Necrosis; Coxa Plana; Osteochondritis)
DefinitionLegg-Calve-Perthes disease (LCPD) is a rare hip disease. It affects children 2-12 years old. LCPD is a disorder of the top of the leg bone. The disorder interrupts blood flow to the hip. The loss of flow causes death of bone and impairs bone growth. Over time, it causes deformity as the bone breaks and reforms causing the child to limp. LCPD most often occurs in just one hip.
|Damage and repairs to the femoral head causes a limp.|
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CausesThe cause of LCPD is unknown. Infection, trauma, and inflammatory processes are possible causes.
Risk FactorsLCPD is more common in male and at ages 4-8 years. It is also more common in children with European, Asian, or Eskimo ancestry. Other factors that may increase your child’s chance of developing LCPD include:
- Small or short for age
- Delayed maturity
- Athletic, active child
- Secondhand smoke exposure
- Blood clotting abnormalities
SymptomsThe primary symptom of LCPD is a limp when walking. This can occur in children 2-12 years old. It peaks in children 4-8 years old. Other symptoms may include:
- Hip pain
- Groin, thigh, or knee pain
- Reduced range of motion in the hip
- Shortening of the leg, or legs that are not the same length
- Muscle weakness in the upper thigh
DiagnosisYou will be asked about your child’s symptoms and medical history. A physical exam will be done. During the exam, your child’s hip will be examined to see how far it can move. The doctor may refer your child to a specialist. An orthopedist focuses on bones and joints.Images may need to be taken of your child's bones. This can be done with:
TreatmentTalk with your doctor about the best plan for you. Options include the following:
Physical TherapyIf your child’s symptoms are mild, your doctor may prescribe physical therapy. A therapist will work with your child to maintain range of motion. You may be taught certain exercises to do with your child at home.
Medical TreatmentMedical treatment is used to improve healing and prevent further injury to the hip. Medical treatment is used to improve healing and prevent further injury to the hip.
- It may include using crutches, traction, a brace, or cast.
- It is usually done before surgery is recommended for children less than 6 years old.
SurgeryIn some cases, your child may need surgery.
- The top of the thigh bone may be resurfaced with metal.
- Bone removal may be done to reposition or reshape the hip bone.
- Rarely, the hip will be replaced.
PreventionThere are no known ways to prevent this rare disease.
Family Doctor—American Academy of Family Physicians
National Osteonecrosis Foundation
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Adkins S, Figler R. Hip pain in athletes. Am Fam Physician. 2000 Apr 1;61(7):2109-2118. Available at: http://www.aafp.org/afp/20000401/2109.html. Accessed March 10, 2015.
Legg-Perthes disease. National Osteonecrosis Foundation website. Available at: http://www.nonf.org/perthesbrochure/perthes-brochure.htm. Accessed March 10, 2015.
Leet AI, Skaggs DL. Evaluation of the acutely limping child. Am Fam Physician. 2000 Feb 15;61(4):1011-1018. Available at: http://www.aafp.org/afp/2000/0215/p1011.html. Accessed March 10, 2015.
- Reviewer: Michael Woods, MD
- Review Date: 03/2015
- Update Date: 02/24/2014
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