Torofy Blog

Depression and Heart Disease

Legg-Calve-Perthes disease

On our Youtube channel, you’ll find a limited
selection of pathology and patient videos. With Osmosis Prime, you’ll get access to over
700 videos including complete coverage of pathology and physiology and a growing collection
of pharmacology and clinical reasoning topics. Try it free today. Legg–Calvé–Perthes disease is a childhood
hip disorder that occurs when the blood supply to the head of femur gets disrupted and leads
to death or necrosis of the tissue. The disease was named after three doctors;
Arthur Legg, Jacques Calvé, and Georg Perthes. The hip joint is a ball and socket type, because
the ball-shaped head of 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 femur is supplied by branches
of 3 arteries, the medial and lateral femoral circumflex arteries, as well as the artery
of ligamentum teres. The arteries send 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 Legg–Calvé–Perthes 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 and that allows the dead tissue to get removed by immune cells
called macrophages. That process causes the head of femur to lose
mass, leaving it weak and prone to fractures. When this happens, the head of femur becomes
misshapen and can no longer smoothly rotate inside the concave acetabulum, which results
in reduced range of motion. Now, over time, Legg–Calvé–Perthes disease
typically self-resolves and the bone is able to heal – once again it’s not known exactly
why or how this happens. When bone remodeling occurs, new bone replaces
the necrosed bone, and the spherical shape of the head of femur gets restored and properly
fits in the acetabulum again. With time, there’s normal functioning of
the joint once more. Children with Legg–Calvé–Perthes 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 your 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 Legg–Calvé–Perthes 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. Legg–Calvé–Perthes 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 femur is very fractured, surgery
may be needed to afix braces and abduct the head of femur, to maintain its spherical shape
as it regenerates. Alright, as a quick recap, … Legg–Calvé–Perthes
disease refers to a childhood hip disorder which occurs when the blood supply to the
head of femur is disrupted for unknown reasons, resulting in avascular necrosis of the head
of 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 the hip surgery may be

24 thoughts on “Legg-Calve-Perthes disease

  1. Reason – Protein C and S deficiency. Venous thrombos formation which compresses the arteries supplying the head of femur leading to necrosis.

  2. The content and illustrations are good, but the voice-narration is excellent! Really commanding, pleasant, and informative narration, I could listen to her all day long. Truly top-notch work, Osmosis!

  3. I just found out that my son has this and didn't understand all the words the doctor said, so it's good to have this video to sum everything up.

  4. my son started limping Oct 22 2018 without any injury.. what depress me as a mother, i went to 3 Ortho yet different Diagnose. 1st ortho says Transient Synovitis, 2nd Juvinile Arthritis and the last one was LEGG CALVE PARTHES … I dont know which of which will i beliv… Rightnow, my son is getting bettert than previous weeks. But still there very very little limping. were planning to go ortho-pedia in Manila next week.

  5. This is a great video describing how Perthes occurs, however, the treatment information is severely lacking and old fashioned. Plus other facts missing such as age range 2-14yrs, 5 to 1 boys are affected compared to girls, 10% get it in both hips, 80% do well with conservative treatment, 20% lead to surgery, deformation of femoral head casuing arthritus and eventual need for hip replacement.

  6. I love your videos, they helped me a lot. To me, this lady's voice does not fit well for an educational video like this. Although her voice is strong and her intonation is flawless, it sometimes grated on my ears. I think these types of videos have to be narrated by a deep voice.

  7. Im a patient of perthes. Ive never really had any issues, however my leg is 3 centimeters shorter then my healthy leg because it didn't have enough blood to grow. Im now fully grown and will have to live with this forever. Great video for anyone who isn't familiar with perthes.
    Edit* i was 7 when they discovered it, im 18 now.

  8. olá .PRECISO DE AJUDA. meu neto de 6 anos com dificuldades em caminhar e dor… foi solicitado um rx de quadril e foi diagnosticado com a doença. estou desesperada e angustiada sem saber o que fazer…preciso aguardar ortopedista pelo sus .e não sei quando irá acontecer esta consulta.preciso de ajuda. NO LAUDO DIZ: ***"importante deformidade e achatamento da cabeça femural relacionado com legg Calvé pertthes"…😭😭😭😭o que eu faço.sei que não posso mais esperar.ele sofre muito e tem muita dificuldade em caminhar.PRECISO DE AJUDA POR FAVOR. Sou deaguardo uma resposta por favor Porto Alegre.. .

  9. my son is 17 years into a hip fusion i am thinking of giving him some vitamins because he has not bent his knee for that long what would be the best ones?

  10. OMG can this person narrating mispronounce "Perthes" anymore? It's pronounced pur thes. I had this disease and there are some things very wrong on here!

  11. I had this when I was 11, now I'm 16 and today it started hurting again and perfect video explained everything on point amazing

  12. I had this age 5, back in 1979. I was in traction for 6 months, with weights stretching my right hip. Then in a wheelchair with bar across my legs for almost 3 and a half years. Amazingly.. I have to say I'm doing pretty well and have played tennis competitively and go running from time to time. I am 46 years old now and fingers crossed it holds up. Ps very VERY good video and nicely explained 👍

  13. I was diagnosed in 1978. Yes it’s tough, but any child will cope and at nearly 50 years old, with nearly no treatment since 10 years old and no medication needed other than the odd flare up, I’ve yet to have a hip replacement. It will come, but it’s not life limiting. In fact it made me more determined in some way.

Leave a Reply

Your email address will not be published. Required fields are marked *