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Radial head subluxation (Nursemaid elbow)
Developmental dysplasia of the hip
Slipped capital femoral epiphysis
Osgood-Schlatter disease (traction apophysitis)
Rotator cuff tear
Radial head subluxation (Nursemaid elbow)
Thoracic outlet syndrome
Carpal tunnel syndrome
Iliotibial band syndrome
Anterior cruciate ligament injury
Patellar tendon rupture
Patellofemoral pain syndrome
Achilles tendon rupture
Degenerative disc disease
Spinal disc herniation
Osteomalacia and rickets
Paget disease of bone
Lordosis, kyphosis, and scoliosis
Juvenile idiopathic arthritis
Calcium pyrophosphate deposition disease (pseudogout)
Inclusion body myopathy
Lambert-Eaton myasthenic syndrome
Systemic lupus erythematosus
Mixed connective tissue disease
Limited systemic sclerosis (CREST syndrome)
Back pain: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Gout and pseudogout: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Scleroderma: Pathology review
Sjogren syndrome: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
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Elizabeth Nixon-Shapiro, MSMI, CMI
Ursula Florjanczyk, MScBMC
Evode Iradufasha, MD
Legg–Calvé–Perthes disease is a childhood hip disorder that occurs when the blood supply to the head of the femur gets disrupted and leads to death or necrosis of the tissue.
The disease was named after three doctors; Arthur Legg, Jacques Calvé, and Georg Perthes.
The hip joint is a ball and socket type, because the ball-shaped head of the femur sits and rotates inside the cup-shaped socket called the acetabulum.
This gives the hip joint the ability to move nearly in all directions, as long as the ball can smoothly rotate inside the socket.
Now, the head of the femur is supplied by branches of 3 arteries, the medial and lateral femoral circumflex arteries, as well as the artery of ligamentum teres.
The arteries send branches that climb up the neck of the femur to supply the head of the femur, providing the tissue with the nutrition it needs to grow and maintain its spherical shape.
In Legg–Calvé–Perthes disease, for some children, the blood supply to the femoral head becomes interrupted for some reason - and it’s not known why exactly.
The result is that the tissue begins to die off - a process called avascular necrosis.
Over time, there’s new blood vessel formation into the necrotized bone and that allows the dead tissue to get removed by immune cells called macrophages.
That process causes the head of the femur to lose mass, leaving it weak and prone to fractures.
When this happens, the head of the femur becomes misshapen and can no longer smoothly rotate inside the concave acetabulum, which results in reduced range of motion.
Now, over time, Legg–Calvé–Perthes disease typically self-resolves and the bone is able to heal - once again it’s not known exactly why or how this happens.
When bone remodeling occurs, new bone replaces the necrosed bone, and the spherical shape of the head of the femur gets restored and properly fits in the acetabulum again.
Legg �Calv� �Perthes disease (LCPD) refers to a childhood hip disorder that occurs when the blood supply to the head of femur is disrupted for unknown reasons, resulting in avascular necrosis of the head of femur. The disease was named after three doctors; Arthur Legg, Jacques Calv�, and Georg Perthes. Children with LCPD develop hip limping and pain which worsens with activity, and it may be referred to the knee. The condition is often treated with surgery and physiotherapy to help restore movement and function.
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