A 7-year-old boy presented with several weeks of left hip and knee pain. On physical exam, he had decreased range of motion of the left hip, especially with internal rotation and abduction. He was diagnosed with Legg-Calve-Perthes disease, which is caused by interruption of blood flow to the capital femoral epiphysis, resulting in bone infarction and fractures. Differential diagnoses included sickle cell disease and septic hip. NSAIDs were prescribed for pain control and orthopedic follow-up was recommended.

2.  7 yo boy presents to the
er complaining of several
weeks of left hips and
knee pain. Mom brings
him in today because she
notes that he has been
limping. They deny
history of trauma. No
fevers, weight changes,
or other complaints.
 PE
 Afebrile. VSS
 Gen: Well appearing,
non-toxic. Short stature.
 Extrem: Decrease ROM
left hip. Esp w/ internal
rotation and abduction

5.  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

6.  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

8.  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.