This is just a different site I copied from, it gives more of the signs and symptoms. I swear, this could have been written after Amaya. She is the textbook case with these symptoms.
One in 1200 children younger than 15 years is affected by LCPD.
Outcome is extremely variable.
Race
Caucasians are affected more frequently than persons of other races.
Sex
Males are affected 4-5 times more often than females.
Age
LCPD most commonly is seen in persons aged 3-12 years, with a median age of 7 years.
Clinical History
Symptoms of Legg-Calv é -Perthes disease usually have been present for weeks because the child often does not complain.
Hip or groin pain, which may be referred to the thigh
Mild or intermittent pain in anterior thigh or knee
Limp
Usually no history of trauma
Physical
Decreased range of motion (ROM), particularly with internal rotation and abduction
Painful gait
Atrophy of thigh muscles secondary to disuse
Muscle spasm
Leg length inequality due to collapse
Thigh atrophy: Thigh circumference on the involved side will be smaller than on the unaffected side secondary to disuse.
Short stature: Children with LCPD often have delayed bone age.
Roll test
With patient lying in the supine position, the examiner rolls the hip of the affected extremity into external and internal rotation.
This test should invoke guarding or spasm, especially with internal rotation.
Causes
The etiology of Legg-Calv é -Perthes disease remains unclear; however, the following scenario generally is accepted:
The blood supply to the capital femoral epiphysis is interrupted.
Bone infarction occurs, especially in the subchondral cortical bone, while articular cartilage continues to grow. (Articular cartilage grows because its nutrients come from the synovial fluid.)
Revascularization occurs, and new bone ossification starts.
At this point, a percentage of patients develop LCPD, while other patients have normal bone growth and development.
LCPD is present when a subchondral fracture occurs. This is usually the result of normal physical activity, not direct trauma to the area
Changes to the epiphyseal growth plate occur secondary to the subchondral fracture.
Follow-up
Legg-Calv é -Perthes disease (LCPD) does not require emergent inpatient care.
Treatment may involve observation, usually in children younger than 6 years.
Bed rest and abduction stretching exercises are recommended.
Nonsurgical containment allows the femoral head to stay within the acetabulum, where it can be molded. Various casts, braces, and crutches have been used for containment.
Initially, close follow-up is required to determine the extent of necrosis.
Once the healing phase has been entered, follow-up can be every 6 months.
Long-term follow-up is necessary to determine the final outcome.
Surgical correction of gross deformities of the femoral head may be necessary.
Complications
LCPD may result in femoral head deformity and degenerative joint disease.
The femoral head may be distorted permanently.
Prognosis
The younger the age of onset of LCPD, the better the prognosis.
Children older than 10 years have a very high risk of developing osteoarthritis.
Most patients have a favorable outcome.
Prognosis is proportional to the degree of radiologic involvement.
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