Legg-Calve-Perthes disease (a condition described by Legg, Calve, Perthes and Waldenstrom in the early 20th century) strikes children and can leave them crippled. Rates vary from 6/100,000 to 15/100,000 depending on the population studied though it appears to be of higher frequency among anglo-saxons.

It is currently believed that osteochondritis dissicans is a local phenomenon of a general condition that effects the epiphyseal cartilage throughout the body due to poor blood supply. It is unknown if this is congenital, developmental, genetic or some combination. Research into the molecular mechanisms of osteochondtritis dissicans is ongoing and when the mechanisms of change to their cells themselves are understood, complete control over this condition will be possible. Medication to prevent this type of change would then be developed and it depending on the origin, it could be screened for in utero or in early life.

None the less, there is no reason to worry- read on.

Children will generally begin limping for no known reason. Atrophy and trendelenberg are usually also present indicating muscle weakness. Decreased ROM in hip flexion and adduction is common and linked with a limp are the telltale signs. Less frequent will be spams of the muscles generally with visible distress from the child. At this point a medical examination and radiological scan will generally be done to determine the cause.

Patients are monitored, given exercises and a brace to wear. If radiological scans indicate a threat to the hip joint, surgery is undertaken. In both cases- over 80% of patients are fully functioning within 2-3 years later. Surgery has the benefit of doing something faster and improves remodeling of the femoral head but this generally appears to be unnecessary in many cases as just as many non-surgical cases improve with bracing and exercise- it simply takes longer. This take of diagnosis requires x-rays and parents/youth coaches should not suspect that a limp is this condition. Children limp for many other, far more common and far less serious reasons. If you suspect a child has this, get an x-ray- it’s easy enough to check and don’t worry yet, 80% of cases are resolved. In the event that it is among the 20%, cartilage and bone necrosis are likely and must be treated aggressively to prevent widespread failure of the structure. Bones which are incapable of weight bearing or securing tendons and ligaments quickly becomes a problem and surgically fixing the bones is the general solution.