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Legg-Calve-PerthesAka: Aseptic Necrosis of the Femoral Head

See Also
1. Pediatric Limp
Epidemiology
1. Children age <10 years
2. Boys affected 4-5 times more often than girls
3. Familial in 20% of cases
4. Incidence 1:1000 to 1:5000
Pathophysiology
1. Juvenile idiopathic avascular necrosis of femoral head
Etiology
1. Idiopathic
Symptoms
1. Pain in area of hip or referred to knee
Signs
1. Child walks with a limp
2. Decreased hip range of motion
Management
1. Difficult management
  1. Long-term treatment
  2. Limited activity
2. Bracing and casting for up to 1-2 years
3. Surgery will allow child back to activity in 4-6 months
Complications
1. Severe degenerative hip disease
  1. Requires hip replacement by middle age in 50% cases
Prognosis
1. Fair at best (see complications above)

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.