Legg-Calve-Perthes disease: Difference between revisions

Revision as of 21:20, 7 June 2011

Background

ischemic necrosis of femoral head
exact mech unknown
more common in boys
10% of cases occur bilaterally
inc 1 per 1200 - 12,000

Diagnosis

Age - 4 to 9 yrs
Present - Painless Limp
Labs - normal
Xrays - Compression, collapse, fragmentation

Presentation

classically a painless limp
may have mild, intermittent pain in hip, groi, thigh or knee
pain often activiity related & relieveed by rest.

Physical Exam

decr range of motion, esp internal rotation and abduction.
may have leg length discrepancy Xrays
initially show increase in articular space or compression of bone
as necrosis progresses, epiphysis will collapse and fragment

Treatment

"Containment" by external orthoses, for up to 18 mo or surgery
50% of untreated get disabling arthritis
younger diagnosed, better prog

@@ Line 1: / Line 1: @@
 ==Background==
+* ischemic necrosis of femoral head
+* exact mech unknown
-- ischemic necrosis of femoral head
+* more common in boys
+* 10% of cases occur bilaterally
-- exact mech unknown
+* inc 1 per 1200 - 12,000
-- more common in boys
-- 10% of cases occur bilaterally
-- inc 1 per 1200 - 12,000
 ==Diagnosis==
+*Age - 4 to 9 yrs
+*Present - Painless Limp
+*Labs - normal
+*Xrays - Compression, collapse, fragmentation
+===Presentation===
+* classically a painless limp
+* may have mild, intermittent pain in hip, groi, thigh or knee
+* pain often activiity related & relieveed by rest.
-Age - 4 to 9 yrs
+===Physical Exam===
+* decr range of motion, esp internal rotation and abduction.
-Present - Painless Limp
+* may have leg length discrepancy Xrays
+* initially show increase in articular space or compression of bone
-Labs - normal
+* as necrosis progresses, epiphysis will collapse and fragment
-Xrays - Compression, collapse, frag-
-mentation
-Presentation
-- classically a painless limp
-- may have mild, intermittent pain in hip, groi, thigh or knee
-- pain often activiity related & relieveed by rest.
-Physical Exam
-- decr range of motion, esp internal rotation and abduction.
-- may have leg length discrepancy Xrays
-- initially show increase in articular space or compression of bone
-- as necrosis progresses, epiphysis will collapse and fragment
 ==Treatment==
+# "Containment" by external orthoses, for up to 18 mo or surgery
+# 50% of untreated get disabling arthritis
-- "Containment" by external orthoses, for up to 18 mo or surgery
+# younger diagnosed, better prog
-- 50% of untreated get disabling arthritis
-- younger diagnosed, better prog
 ==See Also==
+[[Hip Pain (Peds)]]
-Peds:  Hip Pain
 [[Category:Peds]]
+[[Category:Ortho]]