Legg-Calvé-Perthes

What are the signs and symptoms of Legg-Calvé-Perthes disease?

The most common sign of Perthes disease in a child is a painless limp.  Your child may also have pain or stiffness in the hip, groin, thigh, and/or knee and limited range of motion in the hip. As the disease progresses, the symptoms (hip pain and limping) tend to increase.

How is Legg-Calvé-Perthes disease diagnosed?

The diagnosis of Legg-Calvé-Perthes disease (also known as Perthes disease) is based on a detailed history, physical examination and confirmed by imaging.  An x-ray will show the change in the bone structure of the head of the femur.  In certain cases your doctor may choose to have a CT scan of your child’s hip. An MRI is often performed to give the doctor more information about the bone and the extent of the disease process.

Why choose Children’s Colorado Legg-Calvé-Perthes disease tests?

At the Hip Program at Children’s Colorado, our orthopedic providers work specifically with pediatric hip conditions. We use x-rays, CT scans and MRI to determine a diagnosis. 

Our providers are also part of an International Perthes Study Group, with the goal of improved understanding and treatment. Our hospital uses a special MRI technique called Perfusion MRI, which provides your child's doctor with a more accurate measurement of the amount of bone that is affected by Perthes disease. This allows a diagnosis to be made earlier in the disease process and also allows doctors to see implications of how the disease will progress.

What to expect if your child needs testing

X-rays are taken during your visit with the provider, and CT and MRI scans are performed in the radiology department. The CT scans take approximately 15 minutes to complete.

The MRI in patients over 6 years old is typically not a sedated procedure and lasts approximately 45 minutes to one hour. The MRI requires IV placement of contrast before the scan is done. Feel free to bring a movie or music for your child, and have him or her wear comfy clothes to the appointment. 

How do providers at Children’s Colorado make a diagnosis?

Our providers are able to diagnosis your child’s condition based on patient history and age, the results of the physical examination (including pain and/or limitation of motion), and the results of the ordered imaging studies (such as an x-ray or the MRI).

How do we treat Legg-Calvé-Perthes disease at Children’s Hospital Colorado?

Non-Surgical: Non-surgical measures are taken to help with pain and maintain good range of motion in the hip. Anti-inflammatory medication (like Ibuprofen or Naproxen) may be prescribed to help reduce inflammation in the hip and decrease pain. Because of pain and changes to the structure of the head of the femur, children can lose the ability to pull their leg to the side. Casting and/or bracing may be used to preserve the range of motion on the hip and help the head of the femur maintain a round shape.  

Surgical: In some cases, a surgical intervention may be needed. A procedure called a femoral osteotomy will change the way the ball (femoral head) sits inside the  hip socket (acetabulum). An incision is made in the thigh and the femur bone is cut and rotated for better alignment of the femoral head (ball) in the acetabulum (socket). The bone is secured with a metal plate and screws. This surgery is performed to help maintain the femoral head (ball) inside the acetabulum (socket).  

Later in life, once your child’s healing process is complete, a surgical intervention may be necessary if there is femoro-acetabular impingement, which may develop as a result of the change in shape of the end of the thigh bone and the hip socket. Sometimes a surgical intervention is performed on the side of the pelvis to improve the deformity of the hip.

Why choose Children’s Colorado for your child’s Legg-Calvé-Perthes disease?

By working together as a team, we are able to develop a comprehensive approach to both patient diagnosis and individualized treatment plans. Specialists from our Hip Program offer a broad spectrum of options for our patients and extend to include experts in the fields of rehabilitation, physical therapy, rheumatology, anesthesiology and pain.

With a sole focus on hip disease in young patients, our Hip Program is nationally recognized for excellence in hip surgeries, and our doctors educate healthcare providers around the nation on hip diseases and surgery. Our goal is to provide our patients with options for pain control, function improvement, and preservation of the hip joint. We are very proud of being active leaders in the International Perthes Study Group.