• Legg-Calve-Perthes Disease

    (LCPD; Osteonecrosis of the Hip; Avascular Necrosis; Ischemic Necrosis; Coxa Plana; Osteochondritis)


    Legg-Calve-Perthes disease (LCPD) is a rare hip disease. It affects children 2-12 years old. LCPD is a disorder of the top of the leg bone (femoral head). The disorder interrupts blood flow to the hip. The loss of flow impairs bone growth and causes deformity. Over time the bone breaks and reforms causing the child to limp. LCPD most often occurs in just one hip, with only about 10% of cases involving both sides.
    Hip Joint
    hip socket
    Damage and repairs to the femoral head causes a limp.
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    There are many reasons a child may limp. If your child is limping, contact your pediatrician promptly for an evaluation. The sooner this condition is treated the better the outcome.


    The cause of LCPD is unknown. Infection, trauma, and inflammatory processes are possible causes.

    Risk Factors

    These factors increase your child’s chance of developing LCPD. Tell your doctor if your child has any of these risk factors:


    The primary symptom of LCPD is a limp when walking. This can occur in children 2-12 years old. It peaks in children 4-8 years old. Other symptoms may include:
    • Hip pain
    • Groin, thigh, or knee pain
    • Impaired range of motion to hip


    Your doctor will ask about your child’s symptoms and medical history. A physical exam will be done. During the exam, your child’s hip will be examined to see how far it can move. Your doctor may also refer you to a specialist. An orthopedist focuses solely on bones and joints.
    Tests to look for hip damage may include the following:
    • X-ray —test that uses radiation to form a picture of the body’s structures
    • MRI scan —test that uses magnetic waves to form a picture of the body’s structures


    Talk with your doctor about the best plan for you. Options include the following:

    Physical Therapy

    If your child’s symptoms are mild, your doctor may prescribe physical therapy. A therapist will work with your child to maintain range of motion. You may be taught certain exercises to do with your child at home.

    Medical Treatment

    Medical treatment is used to prevent injury to the hip. It may include using crutches , traction, a brace, or cast.
    Medical treatment is used to prevent injury to the hip. It may include using crutches , traction, a brace, or cast.


    In some cases your child may need surgery. An osteotomy (removing some bone) may be done to reposition the hip bone.


    There are no known ways to prevent this rare disease.


    American Academy of Family Physicians http://www.aafp.org

    National Osteonecrosis Foundation http://www.nonf.org/index.html


    The Canadian Orthopaedic Association http://www.coa-aco.org/

    Canadian Orthopaedic Foundation http://www.canorth.org/Default.aspx


    Hip pain in athletes. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000401/2109.html . Accessed October 30, 2008.

    Kleigman, Behrman, Jenson, Stanton, Eds. Nelson Textbook of Pediatrics .18th Edition. Saunders Elsevier, Philadelphia PA, 2007.

    Legg-Perthes disease. National Osteonecrosis Foundation website. Available at: http://www.nonf.org/perthesbrochure/perthes-brochure.htm . Accessed November 3, 2008.

    Lett AI, Skaggs DL. Evaluation of the acutely limping child. American Family Physician website. Available at: http://www.aafp.org/afp/20000215/1011.html/ . Accessed November 3, 2008.

    Taking care of your hip; a physical therapy perspective. American Physical Therapists Association website. Available at: http://www.apta.org/AM/Images/APTAIMAGES/ContentImages/ptandbody/Hip/Hip.pdf . Accessed October 27, 2008.

    Revision Information

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