Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- limp
- limited range of motion at the hip joint
Outros fatores diagnósticos
- short stature
- muscle wasting
- hyperactivity
- Trendelenburg sign
- asymmetric limb length
- knee pain
- thigh pain
- groin/buttock pain
- synovitis
- minor trauma
Fatores de risco
- male sex
- age 4 to 8 years
- low socioeconomic background
- hypercoagulable states
- urban population
- race and northern latitude
- transient hip synovitis
- hip joint effusion
- passive smoking
- skeletal dysplasias
- congenital anomalies
- trisomy 21
- behavior disorders
- endocrinopathy
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- bilateral hip x-rays
Investigações a serem consideradas
- CBC
- serum erythrocyte sedimentation rate
- serum CRP
- bone scintigraphy
- MRI of hips
Algoritmo de tratamento
with acute pain
under 5 years
5 to 7 years
over 7 years to 12 years
over 12 years
Colaboradores
Autores
Andrew Wainwright, FRCS (Tr & Orth) Med
Consultant Orthopaedic Surgeon
Nuffield Orthopaedic Centre
Oxford
UK
Declarações
AW declares that he has no competing interests.
Dominique Knight, BSc, MBBS, FRCS
Consultant Paediatric Orthopaedic Surgeon
Bristol Royal Children’s Hospital
Bristol
UK
Declarações
DK declares that she has no competing interests.
Agradecimentos
Dr Andrew Wainwright and Dr Dominique Knight would like to acknowledge Dr Jwalant S. Mehta and Dr Sandeep Hemmadi, who wrote the original topic and whose work is largely reflected in the current version. JSM and SH declared that they had no competing interests.
Revisores
Phillip Thomas, FRCS (Orth)
Consultant Orthopaedic and Paediatric Orthopaedic Surgeon
Llandough Hospital
Vale of Glamorgan
UK
Declarações
PT declares that he has no competing interests.
Young-Jo Kim, MD, PhD
Associate Professor of Orthopaedic Surgery
Children's Hospital
Boston
MA
Declarações
Not declared.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1981 Sep;63(7):1095-108. Resumo
Catterall A. The natural history of Perthes' disease. J Bone Joint Surg Br. 1971 Feb;53(1):37-53. Resumo
Salter RB, Thompson GH. Legg-Calvé-Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement. J Bone Joint Surg Am. 1984 Apr;66(4):479-89. Resumo
Herring JA, Neustadt JB, Williams JJ, et al. The lateral pillar classification of Legg-Calvé-Perthes disease. J Pediatr Orthop. 1992 Mar-Apr;12(2):143-50. Resumo
Canale ST, D'Anca AF, Cotler JM, et al. Innominate osteotomy in Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1972 Jan;54(1):25-40. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Septic arthritis
- Transient synovitis of the hip
- Sickle cell disease
Mais Diagnósticos diferenciais
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