Beni Rebecca, Hussain Sabba A, Monsell Fergal, Gelfer Yael
City St. George's University of London, London, UK.
St George's University Hospitals NHS Foundation Trust, London, UK.
Arch Dis Child. 2025 Apr 17;110(5):341-346. doi: 10.1136/archdischild-2024-327891.
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.
This review aims to provide a concise overview of the presentation, differential diagnosis and management of LCPD, offering practical guidance for primary healthcare professionals.
Recent literature and expert opinions were reviewed to summarise the epidemiology, diagnosis and current management of LCPD.
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.
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.
Legg-Calve-Perthes病（LCPD）是一种发育性疾病，可导致儿童股骨头缺血性坏死，其长期后果可能延续至成年期。初级保健中的早期诊断和管理至关重要但具有挑战性。
本综述旨在简要概述LCPD的临床表现、鉴别诊断和管理，为初级医疗保健专业人员提供实用指导。
回顾近期文献和专家意见，以总结LCPD的流行病学、诊断和当前管理方法。
LCPD通常表现为2至14岁儿童的无痛性跛行，诊断基于临床特征和影像学异常。管理是个体化的，包括从非手术治疗到手术治疗，旨在纠正解剖学异常，从而延缓骨关节炎的发生。该综述强调了初级保健在早期检测、适当转诊和中期管理中的重要性。
LCPD是一种罕见疾病，可导致长期残疾，影响儿童的身体、心理和社会发展，通常表现为无痛性跛行。诊断通常涉及X线平片，磁共振成像（MRI）或髋关节造影可为管理提供更多细节，管理可能包括非手术（如物理治疗）和手术选择。初级保健提供者的早期识别对于及时转诊至骨科服务至关重要，同时通过物理治疗、疼痛管理以及获得心理健康和教育资源提供中期支持。
