Legg-Calve-Perthes disease

Background

Clinical Features

  • Insidious onset of mild hip pain and limp
    • May have painless limp
    • May have referred pain to groin, thigh, knee
  • Pain often exacerbated by activity, relieved with rest
  • Decreased hip abduction and internal rotation

Differential Diagnosis

Pediatric hip pain

Evaluation

  • Plain radiographs of the hip
    • May be normal early in disease
    • If high suspicion obtain bone scan or MRI
  • Imaging findings:
    • Widening of cartilage space of affected hip
    • Small size ossific nucleus of femoral head
    • Subchondral stress fracture line in femoral head

Management

  • Orthopedic surgery consultation
  • Non-weight bearing
  • Protection of hip joint (maintain in abduction and internal rotation)

Disposition

  • Generally may be discharged
    • Should be done in consultation with orthopedic surgery to ensure appropriate therapy and close follow-up

See Also

References