LEGG-PERTHES DISEASE

General Information

DEFINITION--Gradual weakening of the head of the thigh bone where it meets the pelvis.

BODY PARTS INVOLVED--Either leg at the hip joint (occasionally both).

SEX OR AGE MOST AFFECTED--Older children (4 to 12 years) of both sexes, but more common in boys.

> Pain in the leg--often the knee--

even though the disorder is in the hip.

• Limping.
• Difference in leg length.
• Symptoms usually have a gradual onset.

CAUSES--Unknown. Injury is usually not a factor.

RISK INCREASES WITH

• Use of cortisone drugs for other disorders.
• Overweight.
• Periods of rapid growth.
• Increased incidence in children with low birth weight and delayed development.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms, especially a limp or knee pain in your child.
• Medical history and physical exam by a doctor.
• X-ray of the hip, MRI and bone scan (See Glossary for all).

APPROPRIATE HEALTH CARE

• Doctor's treatment, including consultation with an orthopedist.
• Surgery to reinforce the bone's attachment to the joint and prevent further deformity (sometimes).
• Hospitalization (sometimes) for traction (a steady pull on the leg).

POSSIBLE COMPLICATIONS

• Bone infection.
• Permanent damage to the thigh bone and hip joint.
• Misdiagnosis for hypothyroidism or sickle cell anemia.

PROBABLE OUTCOME--Often curable in 3 to 4 years with early treatment. Delayed treatment may cause permanent bone injury and require surgery to replace the hip.

How To Treat

GENERAL MEASURES--

• Youngsters often have difficulty accepting the need for bed rest, casts, braces or other treatment. Enlist the help of your doctor, a counselor, school nurse or other significant persons, if necessary, to discuss the situation with your child.
• Help your child find activities and interests that don't involve athletics.
• Use heat to relieve pain. Warm compresses, heating pads, whirlpool baths, heat lamps, diathermy and ultrasound are effective.

MEDICATION--For minor discomfort, you may use non-prescription drugs, such as aspirin, acetaminophen or ibuprofen.

ACTIVITY--Bed rest may be necessary for 6 months to 1 year until the condition improves or until after surgery. When the bones can bear weight, crutches, braces or casts are usually necessary. After that, activities may be resumed gradually.

DIET--No special diet, unless the child is overweight.

Call Your Doctor If

• Your child has hip pain, knee pain, stiffness or a limp.
• The following occurs during treatment: Symptoms don't improve in 4 weeks, despite treatment. Pain increases. Temperature rises to 101F (38.3C).