
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Perthes disease
Introduction
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Synonyms and keywords: Juvenile osteochondrosis of head of femur; Perthes disease; Calve-Legg-Perthes disease; coxa plana; ischemic necrosis of the hip; osteochondritis; avascular necrosis of the femoral head; Legg-Perthes Disease; Legg-Calve-Perthes Disease; LCPD
Overview
Overview
Legg-Calvé-Perthes syndrome is a degenerative disease of the hip joint, where a loss of bone mass leads to some degree of collapse of the hip joint, that is, to deformity of the ball of the femur and the surface of the hip socket. The disease is typically found in young children and small dogs, and it can lead to osteoarthritis in adults.
It is the idiopathic avascular osteonecrosis of the capital femoral epiphysis of the femoral head. It is caused by an interruption to the blood supply of the head of the femur close to the hip joint. It is equivalent to adult avascular necrosis.
It is also known as Perthes disease,[1] ischemic necrosis of the hip, coxa plana, osteochondritis and avascular necrosis of the femoral head, or Legg-Perthes Disease or Legg-Calve-Perthes Disease (LCPD).
References
- ↑ G. Perthes. Über Arthritis deformans juvenilis. Deutsche Zeitschrift für Chirurgie, Leipzig, 1910, 107: 111-159.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pathophysiology
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References
Causes
Overview
Causes
The direct cause is a reduction in blood flow to the joint, though what causes this is unknown. It is thought that the artery of the ligamentum teres femoris closes too early, not allowing time for the medial circumflex femoral artery to take over. Genetics does not appear to be a determining factor, though it may be involved. When the disease is genetic in origin, it typically runs along the male line. Some evidence suggests that parental smoking may be a factor, though this is not yet proven, or more recently that a deficiency of some blood factors used to disperse blood clots may lead to blockages in the vessels supplying the joint, but that, too, has not been proven.
References
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Legg-Calvé-Perthes syndrome from other Diseases
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References
Epidemiology and Demographics
Overview
Prevalence
Perthes is a relatively unusual condition, with only 4 per 100,000 children being affected.
Age
It is most commonly seen in persons aged 3-12 years, with a median of 6 years of age.
Gender
Males are affected 4-5 times more often than females, suggesting a partial sex-linked genetic inheritance of the the syndrome. 1 in 100 male children of adults with Legg-Calvé-Perthes syndrome also exhibit the syndrome.
Race
Caucasians are affected more frequently than other races.
References
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural History, Complications and Prognosis
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Overview
Natural History
Complications
Osteoarthritis and coxa magna may develop later in life. Early recognition and proper treatment of Legg-Calve-Perthes disease may minimize this complication.
Prognosis
Children younger than 6 or 7 have the best prognosis since they have time for the dead bone to revascularize and remodel. Children that have been diagnosed with Perthes’ Disease after the age of 10 are at a very high risk of developing osteoarthritis and coxa magna.
References
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | X Ray | MRI | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Physical Therapy | Surgery | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Cafer Zorkun, M.D., Ph.D. [2]
