Dr. M.J. Bazos, Patient Handout

About Your Diagnosis
Legg-Calvé-Perthes disease is a cause of hip pain among children. Legg-Calvé-Perthes disease is a loss of the blood supply to the ball portion of the ball-and-socket hip joint. It usually occurs among children between the ages of 5 and 12 years. The disease is not extremely common, and if it is detected early enough, can be successfully treated. Although symptoms are usually limited to one hip, sometimes they can occur in both hips.

Living With Your Diagnosis
Legg-Calvé-Perthes disease usually begins with hip pain, although some children report pain in the thigh or near the knee. A physical examination shows marked tenderness with rotation of the hip, and the child has a limp. The diagnosis is suggested by the patient’s age and history and the findings at physical examination, but radiographs (x-rays) are needed to confirm the diagnosis. Magnetic resonance imaging (MRI) provides additional information about how much of the femoral head (ball of the hip joint) is involved. The loss of blood supply to the femoral head can lead to collapse and early arthritis and stiffness of the hip joint.

There are no medications, diets, or exercise programs that adequately manage this condition. It has to be evaluated and managed by an orthopedic surgeon who has experience with pediatric patients. The use of body casts or long-leg braces can be inconvenient and uncomfortable for patient and family but is essential to ensure the best possible outcome. The best treatment is early detection. Once the diagnosis has been confirmed by an orthopedic surgeon, several treatment options are available. Depending on the age of the child and the appearance of the joint on radiographs, the patient may be treated with casting, bracing, and sometimes a surgical procedure. Again, there can be side effects and potential complications with each of these forms of treatment. An operation carries with it the risks of anesthesia and surgical manipulation. Risk for infection is always a concern with surgical treatment; however, among children surgical infection is extremely rare.
The DOs
• To relieve itching, use a hair dryer on a cool setting to blow air into the cast or tap on the cast directly over the itch rather than inserting an object into the cast.

The DON’Ts
• Do not insert anything inside the cast to scratch. This can cause a skin sore, which can become infected.

When to Call Your Doctor
• If your child consistently feels pain well localized to a single area beneath the cast. This may be a pressure sore. The physician determines whether inspection of the skin beneath the cast is warranted.
• If redness, swelling, or a foul odor emanates from the cast.
•Ê If after the appropriate treatment regimen has been chosen, there are any deviations from the treatment program.