Beni, R; Hussain, SA; Monsell, F; Gelfer, Y
(2024)
Management of Legg-Calve-Perthes disease: a scoping review with advice on initial management.
Arch Dis Child.
ISSN 1468-2044
https://doi.org/10.1136/archdischild-2024-327891
SGUL Authors: Gelfer, Yael
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Abstract
BACKGROUND: Legg-Calve-Perthes disease (LCPD) is a developmental disorder causing avascular necrosis of the femoral head in children, with long-term consequences that can extend into adulthood. Early diagnosis and management in primary care are crucial but challenging. AIM: This review aims to provide a concise overview of the presentation, differential diagnosis and management of LCPD, offering practical guidance for primary healthcare professionals. METHOD: Recent literature and expert opinions were reviewed to summarise the epidemiology, diagnosis and current management of LCPD. RESULTS: LCPD commonly presents as a painless limp in children aged between 2 and 14 years, with the diagnosis based on the clinical features and radiographic abnormalities. Management is individualised and includes non-operative care to surgery, which attempts to correct anatomical abnormalities and therefore delay the onset of osteoarthritis. The review highlights the importance of primary care in early detection, appropriate referral and interim management. CONCLUSION: LCPD is a rare condition that can lead to long-term disability, affecting a child's physical, mental and social development, often presenting as a painless limp. Diagnosis typically involves plain radiographs, with MRI or hip joint arthrography providing additional details for management, which may include both non-surgical (eg, physiotherapy) and surgical options. Early recognition by primary care providers is crucial for timely referral to orthopaedic services, along with interim support through physiotherapy, pain management and access to mental health and educational resources.
Item Type: | Article |
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Additional Information: | This article has been accepted for publication in Archives of Disease in Childhood, 2024 following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/archdischild-2024-327891. © Author(s) (or their employer(s)) 2024. |
Keywords: | Analgesia, Child Health, Paediatrics, Pain, Paediatrics, Child Health, Pain, Analgesia, Analgesia, Child Health, Paediatrics, Pain, 1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services, Pediatrics |
SGUL Research Institute / Research Centre: | Academic Structure > Institute of Medical, Biomedical and Allied Health Education (IMBE) |
Journal or Publication Title: | Arch Dis Child |
ISSN: | 1468-2044 |
Language: | eng |
Publisher License: | Publisher's own licence |
PubMed ID: | 39613451 |
Web of Science ID: | WOS:001368397100001 |
Go to PubMed abstract | |
URI: | https://openaccess.sgul.ac.uk/id/eprint/117092 |
Publisher's version: | https://doi.org/10.1136/archdischild-2024-327891 |
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