Legg-calve-Perths disease
Legg-Calve-Perthes disease is a childhood disorder, typically affecting children age 2 -12 years, and most common in boys between the ages of 4-10. In this condition the proximal epiphysis within the femoral head becomes partially or completely necrotic due to progressive ischemia and secondary death of osteocytes of the femoral head. This results in the collapsing of bone of the femoral head, increasing the potential for degenerative arthritis. The specific cause of this disease remains unknown. A similar condition that occurs in adults is known as avascular necrosis or ischemic necrosis of the femoral head.
signs and symptoms
- Initial sign is a limp
- Insidious onset
- Slight dragging of the leg
- Slight atrophy of the thigh muscle
- + Trendelenberg sign
- Out toeing of the involved extremity
- Complaints of vague ache in the groin/pelvis that radiates to the medial thigh
- Decreased abduction and internal rotation
- Contracture in hip flexion and adduction
Physical therapy implications
- Refer to pediatric othopeadic specialist
- Physical therapy intervention will vary depending on the treatment chosen by the physician (conservative management or surgery). Surgeon's protocol should be followed post surgery.
References
Campbell S, Palisano R, Orlin M. Physical Therapy for Children. Fourth ed. St. Louis: Elsevier; 2012.
Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2 ed: McGraw-Hill, Medical Publishing Division; 2008.
Lombara A, Granado MJ. Legg-Calve-Perthes Disease. In: Richman S, ed. Ipswich, Massachusetts: EBSCO Publishing; 2012:8p.
Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2 ed: McGraw-Hill, Medical Publishing Division; 2008.
Lombara A, Granado MJ. Legg-Calve-Perthes Disease. In: Richman S, ed. Ipswich, Massachusetts: EBSCO Publishing; 2012:8p.