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Enfermedad de Legg-Calvé-Perthes

Last reviewed: 20 Aug 2025
Last updated: 03 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • cojera
  • rango de movimiento limitado en la articulación de la cadera
Full details

Other diagnostic factors

  • estatura baja
  • pérdida de masa muscular
  • hiperactividad
  • signo de Trendelenburg
  • sinovitis
  • dolor en la rodilla
  • dolor en el muslo
  • dolor en la ingle o los glúteos
  • longitud asimétrica de las extremidades
  • traumatismo menor
Full details

Risk factors

  • sexo masculino
  • 4 a 8 años de edad
  • origen socioeconómico bajo
  • estados de hipercoagulabilidad
  • población urbana
  • raza y latitud norte
  • sinovitis de cadera transitoria
  • derrame articular de la cadera
  • tabaquismo pasivo
  • displasias esqueléticas
  • anomalías congénitas
  • trisomía 21
  • trastornos de la conducta
  • endocrinopatía
Full details

Diagnostic investigations

1st investigations to order

  • radiografías bilaterales de cadera
Full details

Investigations to consider

  • hemograma completo (HC)
  • velocidad de sedimentación globular en suero
  • proteína C-reactiva sérica
  • gammagrafía ósea
  • resonancia magnética (IRM) de las caderas
Full details

Treatment algorithm

ACUTE

con dolor agudo

ONGOING

menores de 5 años de edad

de 5 a 7 años de edad

mayores de 7 hasta 12 años de edad

mayores de 12 años de edad

Contributors

Authors

Andrew Wainwright, FRCS (Tr & Orth) Med

Consultant Orthopaedic Surgeon

Nuffield Orthopaedic Centre

Oxford

UK

Disclosures

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

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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

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