Osteochondritis deformans juvenile
A hip joint disorder where bone growth abnormalities caused by an interrupted blood supply to the head of the femoral bone results in it's degeneration and deformity. When the body creates a new blood supply, new healthy bone can be formed.
* Hip pain * Limited leg motion * Limp * Tender hip muscles * Hip muscle spasm * Degeneration of the femoral head
The exact vascular obstructive changes that initiate Legg-Calvé-Perthes disease are unknown. Current etiological theories include venous obstruction with secondary intraepiphyseal thrombosis, trauma to retinacular vessels, vascular irregularities (congenital or developmental), vascular occlusion secondary to increased intracapsular pressure from acute transient synovitis, and increased blood viscosity resulting in stasis and decreased blood flow. Legg-Calvé-Perthes disease occurs most frequently in boys ages 4 to 10 and tends to occur in families. Although typically unilateral, it occurs bilaterally in 20% of patients.
The signs and symptom information on this page attempts to provide a list of some possible signs and symptoms of Legg-Calvé-Perthes syndrome. This medical information about signs and symptoms for Legg-Calvé-Perthes syndrome has been gathered from various sources, may not be fully accurate, and may not be the full list of Legg-Calvé-Perthes syndrome signs or Legg-Calvé-Perthes syndrome symptoms. Furthermore, signs and symptoms of Legg-Calvé-Perthes syndrome may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Legg-Calvé-Perthes syndrome symptoms.
The aim of treatment is to protect the femoral head from further stress and damage by containing it within the acetabulum. After 1 to 2 weeks of bed rest, therapy may include reduced weight bearing by means of bed rest in bilateral split counterpoised traction, then application of hip abduction splint or cast, or weight bearing while a splint, cast, or brace holds the leg in abduction. Braces may remain in place for 6 to 18 months. Analgesics help relieve pain. Physical therapy with passive and active range-of-motion exercises after cast removal helps restore motion. For a young child in the early stages of the disease, osteotomy and subtrochanteric derotation provide maximum confinement of the epiphysis within the acetabulum to allow return of the femoral head to normal shape and full range of motion. Proper placement of the epiphysis thus allows remolding with ambulation. Postoperatively, the patient requires a spica cast for about 2 months.