Legg-Calve-Perthes Disease | Diagnosis & Treatments

How is Legg-Calve-Perthes disease diagnosed?

Children’s bones heal quickly and have a good capacity for self-repair. Therefore, early diagnosis and treatment of Legg-Calve-Perthes disease allow as much time as possible for the head of your child's thighbone to remodel itself back into a round shape.

In addition to a complete medical history and physical examination, diagnostic procedures for Perthes disease may include:

  • x-ray for information about the structure of the femoral head
  • MRI (magnetic resonance imaging) for information about the severity of the condition
  • blood tests to rule out infection or other conditions

How is Legg-Calve-Perthes disease treated?

Your child’s treatment will depend on their age, range of motion in their hip, and extent of the condition. Your child’s orthopedic specialist will recommend a treatment based on the degree of your child's hip pain, stiffness, and how much of the head of the thighbone has collapsed.

Non-surgical treatments for Legg-Calve-Perthes disease

Non-surgical approaches to treatment may include:

  • activity restrictions
  • anti-inflammatory medication
  • bed rest and traction
  • casting or bracing to:
    • hold the head of the thighbone in the hip socket
    • permit limited joint movement
    • allow the thighbone to remold itself into a round shape
  • physical therapy, to keep the hip muscles strong and promote hip movement

Surgical treatment for Legg-Calve-Perthes disease

If non-surgical treatments prove inadequate, your child may need surgery to hold the head of the thighbone in the hip socket.

A pediatric orthopedic hip specialist can perform a procedure known as a femoral osteotomy, which reorients the way the femoral head fits inside the hip socket. In this procedure, the femur is cut and rotated for better alignment of the femoral head in the hip socket. The bone is then secured with a metal plate and screws.

A femoral head after a femoral osteotomy. The bone has been cut and the top of the femoral head has been repositioned so it will fit more securely in the hip socket. The two pieces of bone are held together with a metal plate.

What is the long-term outlook for children with Legg-Calve-Perthes disease?

The two most important factors that determine your child’s outcome are their age at the onset of treatment (usually, the younger the better) and how much of their femoral head is affected.

Diagnosing and treating your child’s Perthes disease early in its development greatly increases the likelihood of a successful outcome. The majority of children treated for Perthes disease have corrections that enable them to walk, play, grow, and live active lives.

Even after successful treatment in childhood, some children develop hip problems later in life. For this reason, many people with Perthes disease continue to receive follow-up care and monitoring from their pediatric hip specialist into adulthood.