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LEGG-PERTHES DISEASE - THE SILENT HIP INVADER

© TERRIE-LYNN DALEY

LEGG PERTHES DISEASE - THE SILENT HIP INVADER

There has been such an overwhelming response to this article the first time it appeared, I decided to have it appear again, as more and more parents are coming forth about this disease.

I would like to thank my family of November, Howard, Barbara, Evan and Jamie Kelly for bringing this disorder to my attention. I thought it might be of importance to my other readers to learn about it, since it can occur without notice and render a child bedridden.

Legg-Perthes Disease, also known as Legg Calve Perthes Disease, is a gradual weakening of the upper end of the thigh bone at the junction where it meets the pelvis. The right or left hip joint can be involved, and occasionally both are included.

It normally afflicts white caucasian children in the age bracket of 3 to 12 years, with a ratio of 4 boys for every 1 girl that is diagnosed with it. It can be found in boys age 4 to 8 years that have a delayed skeletal maturity.

Some of the first signs are pain and stiffness in the child's hip and thigh or pain in the knee area, accompanied by limping. Other symptoms include groin pain, spasm, decreased internal rotation of leg\hip joint,and buttock atrophy (decrease in size). Even though it makes common sense that when a parent sees a child limping they must have hurt themselves, injury is usually not associated with this disease. Normally, a child that has Legg-Perthes disease comes from a family with a history of hip disorders, uses cortisone drugs for other disorders, suffers from obesity, or experiences periods of rapid growth. Low birth weight and an abnormal pregnancy and\or delivery are also considering factors.

The prognosis for a child with Legg-Perthes disease is usually three to four years of treatment before it is cured if there is early intervention. In the event it is not found until the later stages, permanent bone injury and possible surgery for hip replacement can occur. During the process of the disease, infection in the bones can set in, along with permanent damage to the thigh bone and hip joint. Age is the key in determining prognosis, with at least 50% of hips that are afflicted needing no treatment. Children under the age of 6 years when diagnosed usually have an outcome that is good, regardless of treatment; between 6-8 years of age the results are not always satisfactory even with braces or surgery; children older than 9 years of age have questionable benefit from braces or surgery, and children older than 8-9 years at the initial onset will have poor prognosis and may continue having significant symptoms as they grow older even with bracing or surgery.