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Legg-Calvé-Pertes disease is a childhood hip disorder that occurs when the blood supply to the head of the femur gets disrupted and leads to death or necrosis of the tissue. The disease was named after three doctors, Arthur Legge, Jacques Calvet, and Georg Prates. The hip joint is a ball-and-socket type because the ball-shaped head of the femur sits and rotates inside the cup-shaped socket called the acetabulum.
This gives the hip joint the ability to move nearly in all directions, as long as the ball can smoothly rotate inside the socket. Now, the head of the femur is supplied by branches of three arteries, the medial and lateral femoral circumflex arteries, as well as the artery of ligamentum teres. The arteries are in branches that climb up the neck of the femur to supply the head of the femur, providing the tissue with the nutrition it needs to grow and maintain its spherical shape. In leg calve pertes disease, for some children, the blood supply to the femoral head becomes interrupted for some reason, and it's not known why exactly.
The result is that the tissue begins to die off, a process called avascular necrosis. Over time, there's new blood vessel formation into the necrotized bone that allows the dead tissue to get removed by immune cells called macrophages. That process causes the head of the femur to lose mass, leaving it weak and prone to fractures. When this happens, the head of the femur becomes misshapen and can no longer smoothly rotate inside the concave acetabulum, which results in reduced range of motion. Now, over time, leg calve protez disease typically self-resolves, and the bone is able to heal.
Once again, it's not exactly known why or how this happens. When bone remodeling occurs, new bone replaces a necrosed bone, and the spherical shape of the head of the femur gets restored and properly fits in the acetabulum again. With time, there's normal functioning of the joint once more.
Children with leg calve protez disease develop a limp. and hip pain, which is sometimes referred to the knee. The pain usually gets worse with activity, which may even make the affected hip very difficult to move. This particularly affects abduction, moving the leg laterally away from the body, as well as internal rotation, which is turning your leg inward. Also, because the affected leg is less used, its muscles may become atrophied, causing the leg to look smaller than the normal one.
Diagnosis of leg calve protez disease mainly involves taking x-rays of the hip, which reveal a flattened and misshapen femoral head. In addition, an MRI can be done to see the shape of the bone, as well as look for the formation of new blood vessels. Leg calve protez disease can sometimes resolve by itself over time, so treatment is mainly conservative, involving rest, pain management, and physical therapy to preserve joint mobility.
If the head of the femur is very fractured, Surgery may be needed to affix braces and abduct the head of the femur, to maintain its spherical shape as it regenerates. Alright, as a quick recap, Legg-Calvé-Pertes disease refers to a childhood hip disorder which occurs when the blood supply to the head of the femur is disrupted for unknown reasons, resulting in avascular necrosis of the head of the femur. Children have hip limping and pain which worsens with activity, and it may be referred to the knee. The diagnosis of this disease is mainly done with x-rays and MRI of the limping hip. Its treatment consists of resting the sick hip, having some physical therapy, and managing the pain.
But also, hip surgery may be indicated. Learn medical knowledge more efficiently with Osmosis Prime, the one-stop shop for exclusive videos, personalized study schedules, practice questions, flashcards, and more. Sign up for a free two-week trial today at osmosis.org slash free trial.