During a physical examination, the health care provider will look for a loss in hip motion and a typical limp. A hip x-ray or pelvis x-ray may show signs of Legg-Calve-Perthes disease. An MRI scan may be needed.
The goal of treatment is to keep the ball of the thigh bone inside the socket. Your health care provider may call this "containment." The key to doing this is to make sure the hip has good range of motion. In some cases, bracing is used to help with containment.
Physical therapy and anti-inflammatory medicine (such as ibuprofen) can relieve stiffness in the hip joint. If your hip is painful or the limp gets worse, limiting the amount of weight placed on the leg or restricting activities such as running may help. Nighttime traction devices may also be used.
Health care providers no longer recommend several months of bed rest, although a short period of bed rest may help those with severe pain.
Surgery may be needed if other treatments fail. Surgery ranges from lengthening a groin muscle to major hip surgery to reshape the pelvis, called an osteotomy. The type of surgery depends on the severity of the problem and the shape of the ball of the hip joint.
It is important to have regular follow-up with your doctor and an orthopedic specialist.
The outlook depends on the child's age and the severity of the disease. In general, the younger the child is when the disease starts, the better the outcome.
Children younger than 6 years old who receive treatment are more likely to end up with a normal hip joint. Children older than age 6 are more likely to end up with a deformed hip joint, despite treatment, and may later develop arthritis.
Osteoarthritis may develop later in life. Early recognition and proper treatment of Legg-Calve-Perthes disease may minimize this complication.
Calling your health care provider
Call for an appointment with your health care provider if a child develops any symptoms of this disorder.
McQuillen KK. Musculoskeletal disorders. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 174.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.