7 yo boy presents to the PE er complaining of several Afebrile. VSS weeks of left hips and Gen: Well appearing, knee pain. Mom brings non-toxic. Short stature. him in today because she Extrem: Decrease ROM notes that he has been left hip. Esp w/ internal limping. They deny rotation and abduction history of trauma. No fevers, weight changes, or other complaints.
Consider differential diagnosis – Sickle cell disease, septic hip, trauma Consider CBC and ESR. B/L hip films and frog leg views can be helpful NSAIDs are the mainstay for treatment of pain control Orthopedic follow-up
Caused by interruption of blood flow to the capital femoral epiphysis. Bone infarction occurs and subchondral fractures occur Most common in males. Patients that present at a younger age typically have a better outcome 15-20% of patients have bilateral problems but they are typically at different stages
Nochimson, G et al. “Legg-Calve-Perthes Disease in Emergency Medicine”. Emedicine.com. 4/2011. Tininalli, J et al. “Emergency Medicine: A Comprehensive Study Guide”. 6th ed. 2003 Wheeless, C. “Legg-Calve-Perthes Disease”. Wheelessonline.com. 4/2011.