Diagnosis and Management of Legg-Calvé-Perthes Disease

Clinical Presentation and Diagnosis

• The American College of Radiology recommends considering Legg-Calvé-Perthes disease in children with a Trendelenburg gait, which indicates hip abductor weakness secondary to femoral head involvement, a classic finding in Legg-Calvé-Perthes disease 1, 2
• The absence of fever and normal appearance, combined with a gradual onset, can help rule out septic arthritis and osteomyelitis, according to Praxis Medical Insights 3, 4

Clinical Pitfalls to Avoid

• The American Academy of Pediatrics and other medical societies imply that the absence of fever does not rule out serious pathology, but in this case, the gradual onset and bone scan findings point away from infection, as noted by Praxis Medical Insights 3, 4
• Hip pathology can frequently present as knee pain in up to 30% of cases due to referred pain, but this patient's examination correctly localized to the hip, as reported by Praxis Medical Insights 4