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Legg–Calvé–Perthes Disease, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Idiopathic avascular necrosis of the femoral head in children

  • Genetics:

    • Increased frequency with factor V Leiden and anticardiolipin antibodies

Exclusively a pediatric disease 

Etiology

  • S...

Diagnosis

Signs and Symptoms

History

  • Frequently insidious onset

  • Limp often presenting complaint

  • Pain:

    • Aching in hip, groin, anteromedial thigh, or anteromedial knee

    • May be mild

    • Aggravated by activity, reliev...

Treatment

Pre-Hospital

Clinical course is subacute; less likely to present via ambulance 

Initial Stabilization/Therapy

Not a life-threatening condition; clinical instability mandates identification of a...

Follow-Up

Disposition

Admission Criteria

Need for admission rare, indicated for: 
  • Severe pain or muscle spasm not controlled by PO medications

  • Social considerations; bedrest/care at home not possible

Discharge Criteria

Pearls and Pitfalls

Abrupt onset, presence of fever, unstable patient, or toxic appearance suggest diagnosis other than LCP. 

Additional Reading

  • Daniel  AB, Shah  H, Kamath  A, et al. Environmental tobacco and wood smoke increase the risk of Legg-Calvé-Perthes disease. Clin Orthop Relat Res.  2012;470(9):2369–2375.

  • Dimeg...

Codes

ICD9

732.1 Juvenile osteochondrosis of hip and pelvis 

ICD10

  • M91.10 Juvenile osteochondrosis of head of femur, unspecified leg

  • M91.11 Juvenile osteochondrosis of head of femur, right leg

  • M91.12 Juven...

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