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Legg-Calvé-Perthes disease is idiopathic avascular necrosis of the femoral head due to disruption of blood flow. It typically occurs in children aged 4 to 10 years and is more common in males. Patients typically present with hip pain and a limp, which is exacerbated by activity. Legg-Calvé-Perthes may be diagnosed on radiographs. X-rays may show widening of the cartilage space or a subchondral stress fracture. If left untreated, this will progress to femoral head deformity and subluxation from the acetabulum.
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Management and Disposition
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It is crucial patients have adequate orthopedic follow-up scheduled. Treatment depends on the phase of the disease. Patients with deformity of the femoral head will typically need surgery to prevent progression of malalignment of the hip joint.
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Radiographs may still be normal early during the disease. Bone scan or MRI should be considered.
Legg-Calvé-Perthes disease is an idiopathic condition, so it is important to rule out other potential causes of avascular necrosis including leukemia, sickle cell disease, or corticosteroids.
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