Lecture on Legg-Calvé-Perthes Disease

Overview

• Legg-Calvé-Perthes disease is a childhood hip disorder.
• Occurs due to disruption of blood supply to the head of the femur.
• Leads to avascular necrosis (death of tissue).
• Named after Arthur Legg, Jacques Calvé, and Georg Perthes.

Anatomy of the Hip Joint

• Hip joint: ball-and-socket type.
• Ball-shaped head of the femur rotates in the acetabulum (socket).
• Allows movement in various directions.
• Blood supply to femur head:
  • Medial and lateral femoral circumflex arteries.
  • Artery of ligamentum teres.

Pathophysiology

• Blood supply interruption leads to tissue necrosis (avascular necrosis).
• New blood vessel formation occurs over time.
• Macrophages remove necrotic tissue.
• Femur head loses mass, becomes weak and prone to fractures.
• Misshapen femur head affects joint movement.
• Typically self-resolves over time with unknown mechanisms.
• Bone remodeling restores femur head shape and joint function.

Symptoms

• Children develop a limp and hip pain, sometimes referred to the knee.
• Pain worsens with activity, affecting movement:
  • Abduction (moving leg laterally).
  • Internal rotation (turning leg inward).
• Possible muscle atrophy in the affected leg.

Diagnosis

• Primarily through x-rays revealing flattened, misshapen femoral head.
• MRI can show bone shape and new blood vessel formation.

Treatment

• Conservative management:
  • Resting the affected hip.
  • Pain management.
  • Physical therapy to preserve joint mobility.
• Surgery may be necessary if the femur head is severely fractured.
  • Braces and abduction to maintain femur head shape.

Recap

• Hip disorder due to unknown disruption of blood supply.
• Results in avascular necrosis of the femur head.
• Symptoms include limping and activity-related hip pain.
• Diagnosis via x-rays and MRI.
• Treatment with rest, therapy, and possibly surgery.

Additional Information

• Osmosis Prime offers extensive educational resources:
  • Over 700 videos on pathology, physiology, pharmacology, and clinical reasoning.
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