Patients commonly have a characteristic phenotype of short stature, delayed bone age, and hyperactivity.
Although several aetiologies have been proposed, a multi-factorial involvement is most likely.
Typically unilateral, though bilateral involvement is present in 10% of cases.
Clinical features include a limping gait and hip pain frequently radiating into the thigh, knees, groin, or buttocks. Pain is worse with activities.
Treatment is age-dependent. Options include mobilisation and monitoring, non-surgical or surgical containment, or salvage procedures.
A self-limiting disease of the femoral head comprising of necrosis, collapse, repair, and re-modelling that presents in the first decade of life and is more commonly seen in boys. The cause is hypothesised to be single or multiple vascular events, followed by re-vascularisation. In later life, it can lead to a painful and poorly functioning hip. The disease was first described independently by Jacques Calvé, Arthur T. Legg, and Georg Perthes in 1910.
History and exam
- male sex
- age 4 to 8 years
- socio-economic deprivation
- hyper-coagulable states
- urban population
- Eskimos, Japanese, some central European races
- transient hip synovitis
- hip joint effusion
- passive smoking
- skeletal dysplasias
- congenital anomalies
- trisomy 21
- behaviour disorders
Andrew Wainwright, FRCS (Tr & Orth) Med
Consultant Orthopaedic Surgeon
Nuffield Orthopaedic Centre
AW declares that he has no competing interests.
Dominique Knight, BSc, MBBS, FRCS
Consultant Paediatric Orthopaedic Surgeon
Bristol Royal Children’s Hospital
DK declares that she has no competing interests.
Andrew Wainwright and Dominique Knight would like to acknowledge Jwalant S. Mehta and Sandeep Hemmadi, who wrote the original monograph and whose work is largely reflected in the current version. JSM and SH declare that they have no competing interests.
Phillip Thomas, FRCS (Orth)
Consultant Orthopaedic and Paediatric Orthopaedic Surgeon
Vale of Glamorgan
PT declares that he has no competing interests.
Young-Jo Kim, MD, PhD
Associate Professor of Orthopaedic Surgery
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