Legg Calve Perthes Syndrome Disease

Legg-Calve Perthes Syndrome (Disease): Avascular Necrosis (AVN) of The Femoral Head

Tampa, Saint Petersburg and Clearwater, FL

WHAT IS IT?

LEGG-CALVE-PERTHES has been referred to as a syndrome and also a disease of typically children aged 5-12. It may manifest as arthritis into adulthood.

It occurs when the blood supply to the femoral epiphysis of the femoral head (long bone of the leg) becomes impaired. This loss of blood supply (avascular ) or ischemic change results in cellular death to that region of bone, or as it is referred to as necrosis.

This is reflected in the term avascular necrosis (AVN).

It has also been called:

• Osteonecrosis
• Ischemic necrosis
• Aseptic necrosis
• Bone infarction (ischemic)
• Bone infraction (non-displaced fracture)

HISTORY

Legg-Calve-Perthes was originally described by orthopedic surgeons American Arthur Legg, French Jacque Calve, and German Georg Perthes.

Though the physicians believed different causes: impairment of blood supply to epiphysis, rickets, an infection causing degenerative arthritis respectively.

It is now felt to result from many factors including trauma, loss of blood supply do to circulatory problems, endocrine, hereditary, inflammatory, and nutritional etiologies.

RISK FACTORS

• Impaired or disproportionate growth
• Low birth weight
• Delayed skeletal maturity
• Short stature
• Low socioeconomic level
• Systemic hormonal disturbances

All factors are presumed to alter blood flow to the femoral epiphysis of the femoral head.

SYMPTOMS

Pain with hip or leg movement. Knee or groin referred pain. Difficulty standing, walking, and a painful limp. It may initially be incorrectly labeled growing pains. Leg atrophy or leg length discrepancy may be present.

Boys are affected 4:1 to girls.

Typical onset 5-12 years of age. May present a less than age 2 rarely, and is 90% unilateral.

X-rays and MRI may reveal avascular or osteonecrosis changes, and if joint collapse occurs severe degenerative changes may occur.

TREATMENT (THIS IS PATIENT SPECIFIC NOT A GUIDE)

• Immobilization
• Exercise (swimming and cycling have been favored)
• Surgical considerations
• Stem Cell Therapy

Dennis M. Lox, MD, serves patients in the greater Tampa Bay area, including, Clearwater, St. Petersburg, Tampa, New Port Richey, Sarasota, Orlando and Spring Hill. He has been pleased to accommodate the needs of patients throughout Florida, the United States, the Western Hemisphere, and Europe, as well. Located in the 33765 and 33765 areas, our offices can be reached at (727) 462-5582 (Clearwater) and (727) 817-1909 (New Port Richey). Call to schedule your visit today.