(LCPD; Osteonecrosis of the Hip; Avascular Necrosis; Ischemic Necrosis; Coxa Plana; Osteochondritis)
Legg-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, with only about 10% of cases involving both sides.
The cause of LCPD is unknown. Infection, trauma, and inflammatory processes are possible causes.
LCPD is more common in male and at ages 4-8 years. Othre factors that may increase your child’s chance of developing LCPD include:
- Small or short for age
- Delayed maturity
- Athletic, active child
- Race: Asian, White, Eskimo
- Secondhand smoke exposure
- Blood clotting abnormalities
The 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
Your doctor will ask 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:
Talk with your doctor about the best plan for you. Options include the following:
If 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 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.
There are no known ways to prevent this rare disease.
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 May 7, 2013.
Kleigman, Behrman, et al, Eds. Nelson Textbook of Pediatrics.18th Edition. Saunders Elsevier, Philadelphia PA, 2007.
Legg-Perthes disease. National Osteonecrosis Foundation website. Available at: http://www.nonf.org/perthesbrochure/perthes-brochure.htm. Accessed May 7, 2013.
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 May 7, 2013.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.