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Understanding Legg-Calvé-Perthes Disease

Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder of unknown etiology that can produce permanent deformity of the femoral head. It most commonly affects children aged 5 to 8 years old and presents with mild hip pain, limping, and limited hip motion. Imaging studies such as MRI are important for diagnosis and classification systems like Catterall's help guide treatment, which depends on the child's age at disease onset. Younger children under 6 years often achieve good outcomes with nonsurgical management while older children may benefit from surgical interventions like femoral varus osteotomy.

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Franklin Pito Jella
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367 views19 pages

Understanding Legg-Calvé-Perthes Disease

Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder of unknown etiology that can produce permanent deformity of the femoral head. It most commonly affects children aged 5 to 8 years old and presents with mild hip pain, limping, and limited hip motion. Imaging studies such as MRI are important for diagnosis and classification systems like Catterall's help guide treatment, which depends on the child's age at disease onset. Younger children under 6 years often achieve good outcomes with nonsurgical management while older children may benefit from surgical interventions like femoral varus osteotomy.

Uploaded by

Franklin Pito Jella
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Legg-Calvé-Perthes

Disease
Franklin Pito Jella
Pembimbing: dr Su Djie To Rante, M. Biomed Sp.OT
Learning Object

 Introduction
 Etiology
 Pathogenesis
 Clinical feature
 Classification
 Imaging studies
 Management
Introduction

 Legg-Calvé-Perthes disease (LCPD) is a childhood hip


disorder of unknown etiology that can produce permanent
deformity of the femoral head
 Recent genetic studies on a type II collagen mutation as a
cause of LCPD and studies on the role of inherited
thrombophilia 6-8 on LCPD represent advancement
Etiology

1. Asian families in which multiple members :


 mutation in the type II collagen gene(replacement of glycine with serine
at codon 1170 of COL2A1)

2. Thrombophilia
 75% had a coagulation abnormality (Rare in children)
Pathogenesis
Clinical Features
1.patientspresent with mild pain, a limp, and/or limited hip motion,
2.On physical examination,
Most patients have a mild limp (trendelenburg sign)
Abduction and internal rotation are decrease
Hip motion can become severely restricted
Flexion and adduction contractures
Motion improves during the reossification stage,
Depending on the duration of the disease, thigh and calf muscle atrophy may be
observed as well as limblength discrepancy of 1 to 2.5 cm.

most commonly seen in children aged 5 to 8 years


The male-to-female ratio is approximately 5:1
LCPD is a diagnosis of exclusion
Catterall classification
Catterall classification
Imaging Studies

 AP Lateral oh Both Hip


 Gold standar: Gadolinium-enhanced MRI
Therapy

1. <6 years
2. 6 to 8 years
3. and >8 years
<6 years

 Most patients in whom disease onset occurs


earlier than age 6 years
achieve Stulberg class I/II hips at maturity.
 Another recent retrospective study comparing the
results of Salter innominate osteotomy with
nonsurgical management of Catterall group III/IV
hips found no significant difference between
treatments.
6 to 8 Years

 The PSG study showed no statistically significant


difference between hips in the nonsurgical and surgical
group
 A retrospective study of 640 patients suggests that timing
of femoral varus osteotomy is important and that results
are better with early surgery
> 8 Years

 Suggest superiority of surgical treatments, especially femoral


varus osteotomy, the difference was not found to be
statistically significant
Differential Diagnosis

 Transient Synovitis
 Juvenile Idiopatoc Arthritis (JIA)
 Other Cause Of Osteo Necrosis
HIV
Sicle Cell Disease
Take Home Masage

 Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder


 Although the Catterall and theStulberg classifications are
guides in managing Patient
 Gold standar: Gadolinium-enhanced MRI
 Patients aged <6 years at disease onset appear best treated nonsurgically
 At maturity is need to develop new treatments that specifically address the
biologic and mechanical aspects of the disease
TERIMAKASIH

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