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Legg–calvé–perthes Disease

Legg–calvé–perthes Disease is a topic covered in the 5-Minute Emergency Consult.

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  • Idiopathic avascular necrosis of the femoral head in children
  • Genetics:
    • Increased frequency with factor V Leiden and anticardiolipin antibodies

Pediatric Considerations
Exclusively a pediatric disease


  • Successive vascular occlusions causing characteristic findings
  • Growing evidence implicating hypercoagulable states
  • May be multifactorial
  • Risk factors include tobacco smoke, wood smoke, low birth weight, birth length <50 cm
  • Progression through 4 stages of disease:
    • Initial stage: Dense femoral head causing intermittent synovitis
    • Fragmentation: Femoral head becomes soft and deforms causing loss of motion
    • Healing: New bone grows into femoral head
    • Residual: Healed femoral head with some deformity
  • More common in boys: Male > female, 4:1
  • More common among Caucasians
  • Most commonly occurs between ages of 3 and 7:
    • Range 18 mo–18 yr
  • Bilateral in 10–15% of cases
  • Associated with short stature, deprived populations, delayed & disproportionate growth

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Rosen, Peter, et al., editors. "Legg–calvé–perthes Disease." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307669/all/Legg–calvé–perthes_Disease.
Legg–calvé–perthes Disease. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307669/all/Legg–calvé–perthes_Disease. Accessed June 27, 2019.
Legg–calvé–perthes Disease. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307669/all/Legg–calvé–perthes_Disease
Legg–calvé–perthes Disease [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 27]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307669/all/Legg–calvé–perthes_Disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Legg–calvé–perthes Disease ID - 307669 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307669/all/Legg–calvé–perthes_Disease PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -