Materiały źródłowe

• #1 Legg–Calvé–Perthes disease overview | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02275-z

  LeggCalvPerthes Disease (LCPD) is a necrosis of the femoral head which affects the range of motion of the hips. Its incidence is variable, ranging from 0.4/100,000 to 29.0/ 100,000 children. […] The incidence of LCPD varies widely among countries, cities and races ranging from 0.4/100,000 to 29.0/100,000 children. LCPD usually appears from the age of 3 to 12 years old, with the highest rate of occurrence at the age of 5 to 7 years old. Boys are affected three to five times as often as girls, and the disorder is bilateral in 10-24% of patients, with a correlation to inheritance in approximately 8-12% of patients. […] Although LCPD was first described in the beginning of the past century and has been studied for more than 100 years, limited is known about its etiology. […] The cause of LCPD is unknown. Different etiologies have been proposed; nevertheless, LCPD may be caused by multiple etiologic factors that share a common final pathogenic pathway. A new perspective is that LCPD is a multifactorial disease caused by a combination of environmental, metabolic and genetic factors.

• #2 Frontiers | Progress in understanding Legg–Calvé–Perthes disease etiology from a molecular and cellular biology perspective

  https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1514302/full

  Legg–Calvé–Perthes disease (LCPD) is a hip disease caused by ischemia of the femoral epiphysis in children, which occurs in children aged 4–8 years (mean 6.5 years), with a male-to-female ratio of about 4:1. […] The disease commonly occurs in children aged 4–8 years (average 6.5 years), with an incidence of 0.4/100,000 to 29/100,000, and a male-to-female ratio of about 4:1. Its incidence is associated with regional socioeconomic status, gender, and race. […] The natural course of LCPD is approximately 34 months, and after healing of femoral head necrosis, varying degrees of deformity may persist, with patients at risk of early-onset arthritis after skeletal maturation. […] Although this disease has been reported for over a century, extensive etiological research has been carried out by many scholars, but the exact cause remains uncertain.

• #3 The Epidemiology and Demographics of Legg-Calvé-Perthes’ Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4063164/

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. […] The conventional quotation for the incidence of LCPD is the number per 100,000, usually for age 15 years. The incidence of LCPD ranges widely, from 0.4 in Eastern India (Vellore-Taluk area) to 29.0 in the Faroe Islands (North Atlantic ocean). Significant variability exists within countries, cities, and ethnic groups. […] Many authors have noted differences in incidence by social class and/or inner city/urban/rural location. In the seminal epidemiologic study of 310 children in Edinburgh and Glasgow, Scotland, there was a higher than expected proportion of children with LCPD in lower socioeconomic classes; the same was noted in Liverpool. […] In general, the incidence of LCPD in the British Isles is higher in lower socioeconomic classes and variable regarding rural/urban location.

• #4 Legg Calve Perthes Disease — Pediatric EM Morsels

  https://pedemmorsels.com/legg-calve-perthes-disease/

  Legg Calve Perthes Disease is a Juvenile form of Idiopathic Osteonecrosis of the Femoral Head. [Kim, 2012] […] Incidence = 0.4 29 per 100,000 children (15 years of age) [Loder, 2011] […] The exact etiology, pathogenesis, and epidemiology is still debated. [Cook, 2014; Kim, 2012] […] The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. […] There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes.

• #5 The Epidemiology and Demographics of Legg-Calvé-Perthes’ Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4063164/

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. […] The conventional quotation for the incidence of LCPD is the number per 100,000, usually for age 15 years. The incidence of LCPD ranges widely, from 0.4 in Eastern India (Vellore-Taluk area) to 29.0 in the Faroe Islands (North Atlantic ocean). Significant variability exists within countries, cities, and ethnic groups. […] Many authors have noted differences in incidence by social class and/or inner city/urban/rural location. In the seminal epidemiologic study of 310 children in Edinburgh and Glasgow, Scotland, there was a higher than expected proportion of children with LCPD in lower socioeconomic classes; the same was noted in Liverpool. […] In general, the incidence of LCPD in the British Isles is higher in lower socioeconomic classes and variable regarding rural/urban location.

• #6 Perthes disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/perthes-disease?embed_domain=external.radpair.com%2525252525252527%252525252525255b0%252525252525255dfavicon.icoradiopaedia-icon-144.png&lang=us

  Perthes disease is relatively uncommon and in Western populations has an incidence approaching 5 to 15:100,000. […] Boys are 5x more likely to be affected than girls. Presentation is typically at a younger age than slipped upper femoral epiphysis (SUFE) with peak presentation at 5-6 years, but confidence intervals are as wide as 2-14 years.

• #7 Legg-Calve-Perthes Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1248267-overview

  LCPD usually occurs in children aged 4-10 years (mean age, 7 y). It occurs more commonly in boys than in girls (male-to-female ratio, 4:1). The condition is rare, occurring in approximately 4 of 100,000 children. A British study reported an incidence of 2.8 per 100,000 persons aged 14 years or younger. […] A population-based design study demonstrated that patients with a history of LCPD seem to have a higher risk of severe injury than those without the disease. This risk may be due to a tendency for more hyperactive behavior among LCPD patients, especially females.

• #8 Aetiology of Legg-Calvé-Perthes disease: A systematic review

  https://www.wjgnet.com/2218-5836/full/v10/i3/145.htm

  Legg-Calv-Perthes disease (LCPD) is a clinical condition affecting the femoral head of children during their growth. Its prevalence is set to be between 0.4/100000 to 29.0/100000 children less than 15 years of age with a peak of incidence in children aged from 4 years to 8 years. […] A high profile epidemiological study held in 2017 involving 2.1 million individuals attempted to report a more accurate prevalence of this disease. An overall prevalence of 9.3 per 100000 subjects was found. The male/female ratio was 3.1:1. Even though the study was conducted in Sweden from 1973 to 1993, it is one of the most up-to-date sources of evidence of LCPD epidemiology. […] The literature available on the aetiology of LCPD presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although a lot of studies focused on the genetic, biomechanical and radiological background of the disease, there is a lack of consensus on one or multiple major actors of the etiopathogenesis. More studies are needed to understand the complex and multifactorial genesis of the avascular necrosis characterizing the disease.

• #9 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  Legg-Calve-Perthes disease usually occurs between the ages of 3 to 12 years old, with the highest rate of occurrence at 5 to 7 years. It affects 1 in 1200 children under the age of 15. Legg-Calve-Perthes disease occurs most commonly in male patients, with a male to female ratio between 4:1 and 5:1. It is bilateral in 10% to 20% of affected cases. […] Caucasians and Asians are more commonly affected. It is also more prevalent in urban areas in patients with lower socioeconomic status. Risk factors for Legg-Calve-Perthes disease include:

• #10

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #11 Legg Calve Perthes Disease – OrthoPaedia

  https://www.orthopaedia.com/legg-calve-perthes-disease/

  Legg-Calve-Perthes disease is a relatively rare disease, with a prevalence of approximately 1 in 10,000 children, but can have devastating long-term consequences on the child’s mobility and quality of life. […] The age of onset of Legg-Calve-Perthes disease is most commonly between 4 and 8 years old. In general, it occurs in children under the age of 15 years old. Boys are more commonly affected, with a ratio of male to female of approximately 5:1. In about 10% of all cases, both hips are affected. […] Legg-Calve-Perthes disease is more common in children of central European descent, and less common in East Asian and African American populations.

• #12 Legg–Calvé–Perthes disease – Wikipedia

  https://en.wikipedia.org/wiki/Legg%E2%80%93Calv%C3%A9%E2%80%93Perthes_disease

  The UK incidence rates show an intriguing pattern with low incidence rates in London, and a progressive increase in disease in more northerly areas (maximal in Scotland). […] Some evidence suggests, at least in developed countries, more socioeconomically deprived communities have a greater risk of disease (a similar trend to diseases such as adult heart disease), though the reason for this remains unknown. […] One possible explanation that has been considered is tobacco smoke exposure, though this is significantly confounded by the strong socioeconomic gradient common to both smoking and Perthes’ disease.

• #13

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #14 Legg-Calve-Perthes Disease | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/legg-calve-perthes-disease

  LCPD incidence ranges from three to 15 cases per year per 100,000 children age 0-14 years old (Joseph, 2003). […] Prevalence in several studies varies according to socioeconomic status, geography, race, and education level, with increased numbers seen in those who are less affluent, live in cities or at higher latitude, are Caucasian, or have less educated parents (Joseph, 1988; Wiig, 2006; Perry, 2011; Johansson, 2006; Perry, 2012). […] No matter the social variables, prevalence in males outnumber females at a rate of 3-5:1. […] There is some association with history of smoke exposure.

• #15 The Epidemiology and Demographics of Legg-Calvé-Perthes’ Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4063164/

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. […] The conventional quotation for the incidence of LCPD is the number per 100,000, usually for age 15 years. The incidence of LCPD ranges widely, from 0.4 in Eastern India (Vellore-Taluk area) to 29.0 in the Faroe Islands (North Atlantic ocean). Significant variability exists within countries, cities, and ethnic groups. […] Many authors have noted differences in incidence by social class and/or inner city/urban/rural location. In the seminal epidemiologic study of 310 children in Edinburgh and Glasgow, Scotland, there was a higher than expected proportion of children with LCPD in lower socioeconomic classes; the same was noted in Liverpool. […] In general, the incidence of LCPD in the British Isles is higher in lower socioeconomic classes and variable regarding rural/urban location.

• #16 Legg-Calve-Perthes Disease | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/legg-calve-perthes-disease

  LCPD incidence ranges from three to 15 cases per year per 100,000 children age 0-14 years old (Joseph, 2003). […] Prevalence in several studies varies according to socioeconomic status, geography, race, and education level, with increased numbers seen in those who are less affluent, live in cities or at higher latitude, are Caucasian, or have less educated parents (Joseph, 1988; Wiig, 2006; Perry, 2011; Johansson, 2006; Perry, 2012). […] No matter the social variables, prevalence in males outnumber females at a rate of 3-5:1. […] There is some association with history of smoke exposure.

• #17 The Epidemiology and Demographics of Legg-Calvé-Perthes’ Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4063164/

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. […] The conventional quotation for the incidence of LCPD is the number per 100,000, usually for age 15 years. The incidence of LCPD ranges widely, from 0.4 in Eastern India (Vellore-Taluk area) to 29.0 in the Faroe Islands (North Atlantic ocean). Significant variability exists within countries, cities, and ethnic groups. […] Many authors have noted differences in incidence by social class and/or inner city/urban/rural location. In the seminal epidemiologic study of 310 children in Edinburgh and Glasgow, Scotland, there was a higher than expected proportion of children with LCPD in lower socioeconomic classes; the same was noted in Liverpool. […] In general, the incidence of LCPD in the British Isles is higher in lower socioeconomic classes and variable regarding rural/urban location.

• #18 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  Legg-Calve-Perthes disease usually occurs between the ages of 3 to 12 years old, with the highest rate of occurrence at 5 to 7 years. It affects 1 in 1200 children under the age of 15. Legg-Calve-Perthes disease occurs most commonly in male patients, with a male to female ratio between 4:1 and 5:1. It is bilateral in 10% to 20% of affected cases. […] Caucasians and Asians are more commonly affected. It is also more prevalent in urban areas in patients with lower socioeconomic status. Risk factors for Legg-Calve-Perthes disease include:

• #19

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #20 The Epidemiology and Demographics of Legg-Calvé-Perthes’ Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4063164/

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. […] The conventional quotation for the incidence of LCPD is the number per 100,000, usually for age 15 years. The incidence of LCPD ranges widely, from 0.4 in Eastern India (Vellore-Taluk area) to 29.0 in the Faroe Islands (North Atlantic ocean). Significant variability exists within countries, cities, and ethnic groups. […] Many authors have noted differences in incidence by social class and/or inner city/urban/rural location. In the seminal epidemiologic study of 310 children in Edinburgh and Glasgow, Scotland, there was a higher than expected proportion of children with LCPD in lower socioeconomic classes; the same was noted in Liverpool. […] In general, the incidence of LCPD in the British Isles is higher in lower socioeconomic classes and variable regarding rural/urban location.

• #21 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  Legg-Calve-Perthes disease usually occurs between the ages of 3 to 12 years old, with the highest rate of occurrence at 5 to 7 years. It affects 1 in 1200 children under the age of 15. Legg-Calve-Perthes disease occurs most commonly in male patients, with a male to female ratio between 4:1 and 5:1. It is bilateral in 10% to 20% of affected cases. […] Caucasians and Asians are more commonly affected. It is also more prevalent in urban areas in patients with lower socioeconomic status. Risk factors for Legg-Calve-Perthes disease include:

• #22

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #23 Legg-Calve-Perthes Disease | PM&R KnowledgeNow

  https://now.aapmr.org/legg-calve-perthe-disease/

  The disease affects children between ages 3 and 12 with a peak incidence between ages 5 and 7. LCPD is a rare, afflicting 1 in 1200 children. The male to female ratio is 4 to 5:1; most commonly unilateral with 10-24% of cases are bilateral. The disease is much more common in Caucasian children with declining incidence in Asian and African American populations. There is a significant geographic variation among countries. Equatorial regions have a low incidence of the disease, whereas Northern Europe has the highest documented incidence. Risk factors include exposure to secondhand smoke, hyperactive behavior, and children small for their age. […] The imaging study for the diagnosis and surveillance of LCPD is an anterior-posterior and lateral pelvis radiograph. It is important to assess the integrity and shape of the FH using the above-mentioned four stages. If early film is negative and the symptoms are recent, the radiograph should be repeated in one month. The gold standard is dynamic contrast enhanced subtraction MRI as it better delineates blood flow to the FH for early ischemia detection, correlates well with bone scintigraphy, provides prognostic value with physeal involvement and is more sensitive than radiography.

• #24 Network Analysis of Legg–Calve–Perthes Disease and Its Comorbidities

  https://www.mdpi.com/2077-0383/14/1/259

  Legg–Calvé–Perthes disease (LCPD) is characterized by idiopathic avascular necrosis of the femoral head in children, with an incidence between 0.4 and 29.0 per 100,000 people. […] Smoking habits and obesity are strongly associated with LCPD according to recent studies. […] The incidence in Caucasians has been reported to range from 4.4 to 16.9 per 100,000 in England and from 5.7 to 10 in the United States; in Japanese children, 0.9/100,000; and in Hong Kong, 0.2/100,000. […] In our study using big data from the NHIS-NSC database, the average incidence of Korean children from 2003 to 2015 was 9.3 in boys and 3.4 in girls, showing a nearly 3:1 ratio with a greater incidence in boys. […] We confirmed the association between LCPD and comorbidities using a network analysis. The LCPD comorbidity network identified in this study is expected to serve as the basis for future research on LCPD.

• #25

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #26 Legg-Calve-Perthes Disease | PM&R KnowledgeNow

  https://now.aapmr.org/legg-calve-perthe-disease/

  The disease affects children between ages 3 and 12 with a peak incidence between ages 5 and 7. LCPD is a rare, afflicting 1 in 1200 children. The male to female ratio is 4 to 5:1; most commonly unilateral with 10-24% of cases are bilateral. The disease is much more common in Caucasian children with declining incidence in Asian and African American populations. There is a significant geographic variation among countries. Equatorial regions have a low incidence of the disease, whereas Northern Europe has the highest documented incidence. Risk factors include exposure to secondhand smoke, hyperactive behavior, and children small for their age. […] The imaging study for the diagnosis and surveillance of LCPD is an anterior-posterior and lateral pelvis radiograph. It is important to assess the integrity and shape of the FH using the above-mentioned four stages. If early film is negative and the symptoms are recent, the radiograph should be repeated in one month. The gold standard is dynamic contrast enhanced subtraction MRI as it better delineates blood flow to the FH for early ischemia detection, correlates well with bone scintigraphy, provides prognostic value with physeal involvement and is more sensitive than radiography.

• #27 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  Legg-Calve-Perthes disease usually occurs between the ages of 3 to 12 years old, with the highest rate of occurrence at 5 to 7 years. It affects 1 in 1200 children under the age of 15. Legg-Calve-Perthes disease occurs most commonly in male patients, with a male to female ratio between 4:1 and 5:1. It is bilateral in 10% to 20% of affected cases. […] Caucasians and Asians are more commonly affected. It is also more prevalent in urban areas in patients with lower socioeconomic status. Risk factors for Legg-Calve-Perthes disease include:

• #28 Legg–Calvé–Perthes disease overview | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02275-z

  LeggCalvPerthes Disease (LCPD) is a necrosis of the femoral head which affects the range of motion of the hips. Its incidence is variable, ranging from 0.4/100,000 to 29.0/ 100,000 children. […] The incidence of LCPD varies widely among countries, cities and races ranging from 0.4/100,000 to 29.0/100,000 children. LCPD usually appears from the age of 3 to 12 years old, with the highest rate of occurrence at the age of 5 to 7 years old. Boys are affected three to five times as often as girls, and the disorder is bilateral in 10-24% of patients, with a correlation to inheritance in approximately 8-12% of patients. […] Although LCPD was first described in the beginning of the past century and has been studied for more than 100 years, limited is known about its etiology. […] The cause of LCPD is unknown. Different etiologies have been proposed; nevertheless, LCPD may be caused by multiple etiologic factors that share a common final pathogenic pathway. A new perspective is that LCPD is a multifactorial disease caused by a combination of environmental, metabolic and genetic factors.

• #29 Frontiers | Progress in understanding Legg–Calvé–Perthes disease etiology from a molecular and cellular biology perspective

  https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1514302/full

  Legg–Calvé–Perthes disease (LCPD) is a hip disease caused by ischemia of the femoral epiphysis in children, which occurs in children aged 4–8 years (mean 6.5 years), with a male-to-female ratio of about 4:1. […] The disease commonly occurs in children aged 4–8 years (average 6.5 years), with an incidence of 0.4/100,000 to 29/100,000, and a male-to-female ratio of about 4:1. Its incidence is associated with regional socioeconomic status, gender, and race. […] The natural course of LCPD is approximately 34 months, and after healing of femoral head necrosis, varying degrees of deformity may persist, with patients at risk of early-onset arthritis after skeletal maturation. […] Although this disease has been reported for over a century, extensive etiological research has been carried out by many scholars, but the exact cause remains uncertain.

• #30 Legg–Calvé–Perthes disease – Wikipedia

  https://en.wikipedia.org/wiki/Legg%E2%80%93Calv%C3%A9%E2%80%93Perthes_disease

  Perthes’ disease is one of the most common hip disorders in young children, occurring in roughly 5.5 of 100,000 children per year. The lifetime risk of a child developing the disease is about one per 1,200 individuals. Boys are affected about three to five times more often than girls. New cases of Perthes’ disease rarely occur after age 14 years (if diagnosed after 14 years of age, then it is usually old disease from early in childhood or avascular necrosis from an alternative cause). […] White northern Europeans appear to be affected more frequently than other ethnicities, though a paucity of reliable epidemiology exists in the Southern Hemisphere. […] Children of those with the disease themselves may have a very slightly increased risk, though it is unclear if this is because of a genetic predisposition, or a shared environmental factor. It is most commonly seen in persons aged three to twelve years, with a median of six years of age.

• #31 The epidemiology and demographics of legg-calvé-perthes’ disease. | Read by QxMD

  https://read.qxmd.com/read/24977062/the-epidemiology-and-demographics-of-legg-calv-perthes-disease

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. The typical age at presentation ranges from 4 to 8 years (average 6.5 years), except for children from the Indian subcontinent (average 9.5 years). […] There is a mild familial component. […] LCPD can be associated with abnormalities in the coagulation cascade, including an increase in factor V Leiden mutation, low levels of protein C and/or S, and decreased antithrombin activity. […] Children with LCPD are active and score abnormally in certain standardized psychological tests.

• #32 The association between attention deficit hyperactivity disorder and Legg–Calvé–Perthes disease in tertiary hospital-Riyadh City, Saudi Arabia – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/the-association-between-attention-deficit-hyperactivity-disorder-and-legg-calv-perthes-disease-in-tertiary-hospital-riyadh-city-saudi-arabia/

  LeggCalvPerthes Disease (LCPD) is a juvenile hip disorder in which interruption to the blood supply of the femoral head causes osteonecrosis. […] It is estimated that the incidence of LCPD is from 4 to 290 in a million children younger than 15 years. […] Significant variability is found when considering the extent of LCPD within ethnic groups, and it is found to be more in lower socioeconomic classes. […] The classical age at presentation is usually around 48 years (average 6.5 years), except for children from the Indian subcontinent (average 9.5 years). […] Patients with LCPD usually present with intermittent leg, thigh, and groin pain, which increases with movement. […] The diagnosis can be made with proper history taking, physical examination, and imaging studies. […] The current study aims to investigate the relationship between ADHD and LCPD among young Saudi population.

• #33 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  Legg-Calve-Perthes disease usually occurs between the ages of 3 to 12 years old, with the highest rate of occurrence at 5 to 7 years. It affects 1 in 1200 children under the age of 15. Legg-Calve-Perthes disease occurs most commonly in male patients, with a male to female ratio between 4:1 and 5:1. It is bilateral in 10% to 20% of affected cases. […] Caucasians and Asians are more commonly affected. It is also more prevalent in urban areas in patients with lower socioeconomic status. Risk factors for Legg-Calve-Perthes disease include:

• #34 Legg–Calvé–Perthes disease overview | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02275-z

  LeggCalvPerthes Disease (LCPD) is a necrosis of the femoral head which affects the range of motion of the hips. Its incidence is variable, ranging from 0.4/100,000 to 29.0/ 100,000 children. […] The incidence of LCPD varies widely among countries, cities and races ranging from 0.4/100,000 to 29.0/100,000 children. LCPD usually appears from the age of 3 to 12 years old, with the highest rate of occurrence at the age of 5 to 7 years old. Boys are affected three to five times as often as girls, and the disorder is bilateral in 10-24% of patients, with a correlation to inheritance in approximately 8-12% of patients. […] Although LCPD was first described in the beginning of the past century and has been studied for more than 100 years, limited is known about its etiology. […] The cause of LCPD is unknown. Different etiologies have been proposed; nevertheless, LCPD may be caused by multiple etiologic factors that share a common final pathogenic pathway. A new perspective is that LCPD is a multifactorial disease caused by a combination of environmental, metabolic and genetic factors.

• #35

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #36 Aetiology of Legg-Calvé-Perthes disease: A systematic review

  https://www.wjgnet.com/2218-5836/full/v10/i3/145.htm

  Legg-Calv-Perthes disease (LCPD) is a clinical condition affecting the femoral head of children during their growth. Its prevalence is set to be between 0.4/100000 to 29.0/100000 children less than 15 years of age with a peak of incidence in children aged from 4 years to 8 years. […] A high profile epidemiological study held in 2017 involving 2.1 million individuals attempted to report a more accurate prevalence of this disease. An overall prevalence of 9.3 per 100000 subjects was found. The male/female ratio was 3.1:1. Even though the study was conducted in Sweden from 1973 to 1993, it is one of the most up-to-date sources of evidence of LCPD epidemiology. […] The literature available on the aetiology of LCPD presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although a lot of studies focused on the genetic, biomechanical and radiological background of the disease, there is a lack of consensus on one or multiple major actors of the etiopathogenesis. More studies are needed to understand the complex and multifactorial genesis of the avascular necrosis characterizing the disease.

• #37 Legg-Calvé-Perthes Disease | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116343/all/Legg_Calv%C3%A9_Perthes_Disease?q=Calf+pain

  Legg-Calv-Perthes disease (LCPD) is a hip disorder secondary to idiopathic ischemic osteonecrosis of the femoral head. […] Predominant age: Susceptible age is 2 to 12 years. ~80% occurs between the ages of 4 and 9 years. […] Predominant sex: male female (4:1) […] In bilateral cases, males predominate (7:1). However, females seem to have more severe involvement. […] Annual international incidence of 1:1,200 […] Prevalence 5:100,000.

• #38 Interactive Journal of Medical Research – Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

  https://www.i-jmr.org/2021/2/e27075

  Legg-Calv-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. […] The disease has a poor prognosis in children over 8 years old, but this group of patients can also benefit from advanced surgical methods. […] The prevalence of the disease is higher in boys than in girls. […] Current literature suggests that between 30% and 50% of children affected by LCPD will experience hip symptoms in adulthood. […] The incidence rate is between 0.2 and 19.1 per 100,000 people. […] The prevalence of Perthes disease in boys is five times more than in girls, and 10% to 15% of patients are affected bilaterally; however, bilateral cases are more common in girls. […] The treatment of Perthes disease depends on the age and stage of presentation.

• #39 Legg-Calve-Perthes Disease | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/legg-calve-perthes-disease

  About one out of every 12,000 children develop Perthes disease. Boys are five times more likely to be affected than girls, but when girls are affected, the condition tends to be more severe. […] Perthes disease most often affects children who are between 4 and 10 years old, very physically active, and small for their age. The condition tends to be more common in children who have been exposed to second-hand smoke. […] Specialists in Boston Childrens Child and Young Adult Hip Preservation Program have deep experience diagnosing and treating children with Legg-Calve-Perthes disease. In fact, Boston Childrens orthopedic surgeon Arthur Thornton Legg, MD, was the one of the first to recognize and describe Legg-Calve-Perthes disease in 1910. Our specialists have continued to lead the way in pioneering advanced techniques for treating this condition.

• #40 Legg-Calvé-Perthes Disease | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116343/all/Legg_Calv%C3%A9_Perthes_Disease?q=Calf+pain

  Legg-Calv-Perthes disease (LCPD) is a hip disorder secondary to idiopathic ischemic osteonecrosis of the femoral head. […] Predominant age: Susceptible age is 2 to 12 years. ~80% occurs between the ages of 4 and 9 years. […] Predominant sex: male female (4:1) […] In bilateral cases, males predominate (7:1). However, females seem to have more severe involvement. […] Annual international incidence of 1:1,200 […] Prevalence 5:100,000.

• #41 Legg–Calvé–Perthes disease overview | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02275-z

  LeggCalvPerthes Disease (LCPD) is a necrosis of the femoral head which affects the range of motion of the hips. Its incidence is variable, ranging from 0.4/100,000 to 29.0/ 100,000 children. […] The incidence of LCPD varies widely among countries, cities and races ranging from 0.4/100,000 to 29.0/100,000 children. LCPD usually appears from the age of 3 to 12 years old, with the highest rate of occurrence at the age of 5 to 7 years old. Boys are affected three to five times as often as girls, and the disorder is bilateral in 10-24% of patients, with a correlation to inheritance in approximately 8-12% of patients. […] Although LCPD was first described in the beginning of the past century and has been studied for more than 100 years, limited is known about its etiology. […] The cause of LCPD is unknown. Different etiologies have been proposed; nevertheless, LCPD may be caused by multiple etiologic factors that share a common final pathogenic pathway. A new perspective is that LCPD is a multifactorial disease caused by a combination of environmental, metabolic and genetic factors.

• #42

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #43 Legg-Calve-Perthes Disease | PM&R KnowledgeNow

  https://now.aapmr.org/legg-calve-perthe-disease/

  The disease affects children between ages 3 and 12 with a peak incidence between ages 5 and 7. LCPD is a rare, afflicting 1 in 1200 children. The male to female ratio is 4 to 5:1; most commonly unilateral with 10-24% of cases are bilateral. The disease is much more common in Caucasian children with declining incidence in Asian and African American populations. There is a significant geographic variation among countries. Equatorial regions have a low incidence of the disease, whereas Northern Europe has the highest documented incidence. Risk factors include exposure to secondhand smoke, hyperactive behavior, and children small for their age. […] The imaging study for the diagnosis and surveillance of LCPD is an anterior-posterior and lateral pelvis radiograph. It is important to assess the integrity and shape of the FH using the above-mentioned four stages. If early film is negative and the symptoms are recent, the radiograph should be repeated in one month. The gold standard is dynamic contrast enhanced subtraction MRI as it better delineates blood flow to the FH for early ischemia detection, correlates well with bone scintigraphy, provides prognostic value with physeal involvement and is more sensitive than radiography.

• #44 Interactive Journal of Medical Research – Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

  https://www.i-jmr.org/2021/2/e27075

  Legg-Calv-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. […] The disease has a poor prognosis in children over 8 years old, but this group of patients can also benefit from advanced surgical methods. […] The prevalence of the disease is higher in boys than in girls. […] Current literature suggests that between 30% and 50% of children affected by LCPD will experience hip symptoms in adulthood. […] The incidence rate is between 0.2 and 19.1 per 100,000 people. […] The prevalence of Perthes disease in boys is five times more than in girls, and 10% to 15% of patients are affected bilaterally; however, bilateral cases are more common in girls. […] The treatment of Perthes disease depends on the age and stage of presentation.

• #45

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #46

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #47 Legg–Calvé–Perthes disease overview | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02275-z

  LeggCalvPerthes Disease (LCPD) is a necrosis of the femoral head which affects the range of motion of the hips. Its incidence is variable, ranging from 0.4/100,000 to 29.0/ 100,000 children. […] The incidence of LCPD varies widely among countries, cities and races ranging from 0.4/100,000 to 29.0/100,000 children. LCPD usually appears from the age of 3 to 12 years old, with the highest rate of occurrence at the age of 5 to 7 years old. Boys are affected three to five times as often as girls, and the disorder is bilateral in 10-24% of patients, with a correlation to inheritance in approximately 8-12% of patients. […] Although LCPD was first described in the beginning of the past century and has been studied for more than 100 years, limited is known about its etiology. […] The cause of LCPD is unknown. Different etiologies have been proposed; nevertheless, LCPD may be caused by multiple etiologic factors that share a common final pathogenic pathway. A new perspective is that LCPD is a multifactorial disease caused by a combination of environmental, metabolic and genetic factors.

• #48 Legg-Calvé-Perthes Disease – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/bone-disorders-in-children/legg-calv%C3%A9-perthes-disease

  Legg-Calv-Perthes disease has a maximum incidence at age 5 to 10 years, is more common among boys, and is usually unilateral. […] About 10% of cases are familial, but contributing gene defects have not been identified. […] In bilateral or familial cases, an x-ray skeletal survey to exclude hereditary skeletal disorders, particularly multiple epiphyseal dysplasia, is mandatory because prognosis and optimal management differ.

• #49 Legg-Calvé-Perthes Disease | Concise Medical Knowledge

  https://www.lecturio.com/concepts/legg-calve-perthes-disease-lcpd/

  Legg-Calv-Perthes disease primarily affects school-age children and has a male predominance. […] Affects 1 in 1,200 people in the United States. […] Male-to-female ratio: 4:1. […] Peak incidence between 4 and 8 years of age. […] 8590% of cases are unilateral (up to 15% may present with bilateral or sequential involvement). […] Highest incidence: White populations. […] Lowest incidence: East Asian populations. […] More prevalent in urban areas in patients with lower socioeconomic status. […] 10% of cases are familial. […] Up to 5% of patients with HIV have avascular necrosis of the hip. […] The interruption of blood flow to the capital femoral epiphysis is the inciting cause.

• #50 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  This incidence of LCPD in relatives is much higher (35 times) than that in the general population. […] These studies raise the possibility of a strong genetic component in the etiology of LCPD. […] The occurrence of LCPD-like hip changes in a few inherited dysplasias of the skeleton, such as trichorhinophalangeal syndrome and Floating-Harbor syndrome, also suggests the presence of major genetic defects underlying LCPD.

• #51 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  This incidence of LCPD in relatives is much higher (35 times) than that in the general population. […] These studies raise the possibility of a strong genetic component in the etiology of LCPD. […] The occurrence of LCPD-like hip changes in a few inherited dysplasias of the skeleton, such as trichorhinophalangeal syndrome and Floating-Harbor syndrome, also suggests the presence of major genetic defects underlying LCPD.

• #52 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  This incidence of LCPD in relatives is much higher (35 times) than that in the general population. […] These studies raise the possibility of a strong genetic component in the etiology of LCPD. […] The occurrence of LCPD-like hip changes in a few inherited dysplasias of the skeleton, such as trichorhinophalangeal syndrome and Floating-Harbor syndrome, also suggests the presence of major genetic defects underlying LCPD.

• #53 Frontiers | Progress in understanding Legg–Calvé–Perthes disease etiology from a molecular and cellular biology perspective

  https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1514302/full

  The etiology of LCPD was fully elaborated by Rodríguez-Olivas et al. (2022), who suggested that LCPD may be correlated with factors such as the environment, race, and coagulation. […] In recent years, significant progress has been made in etiological research on LCPD. […] The mainstream view holds that maternal passive smoking and/or postnatal infant tobacco exposure are closely related to the onset of LCPD. […] In a retrospective analysis by Swedish scholars of 852 LCPD patients, maternal tobacco exposure during pregnancy was found to significantly increase the risk of LCPD in offspring. […] Recent studies suggest that endothelial cell structural or functional abnormalities exist in LCPD patients. […] This hypothesis is supported by epidemiological and clinical examinations. […] The interruption of blood supply to the femoral head epiphysis is an established mechanism of LCPD, but research has largely focused on extravascular factors, with little emphasis on the functional state of the vessels themselves. […] This result suggests that vascular dysfunction may be prevalent among LCPD patients.

• #54 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  A strong correlation has also been described with maternal smoking as well as exposure to second-hand smoke. […] Moreover, high rates of obesity and hypertension were also identified in a group of children having LCPD. […] The cause of the LCPD is largely unknown, though, many experimental and clinical studies provide support to the idea that the temporary disruption of the blood supply to the femoral head is a key event in the pathogenesis of the disease. […] The underlying cause may be disruption of supply of blood to the femoral epiphysis due to trauma, coagulopathy, or the use of steroids. […] The two processes have been suggested to play an essential role in the pathogenesis of osteonecrosis. […] This is supported by the fact that thrombophilia and some forms of coagulopathy are present in approximately 50% and 75% of the LCPD patients, respectively.

• #55

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #56 Frontiers | Progress in understanding Legg–Calvé–Perthes disease etiology from a molecular and cellular biology perspective

  https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1514302/full

  The etiology of LCPD was fully elaborated by Rodríguez-Olivas et al. (2022), who suggested that LCPD may be correlated with factors such as the environment, race, and coagulation. […] In recent years, significant progress has been made in etiological research on LCPD. […] The mainstream view holds that maternal passive smoking and/or postnatal infant tobacco exposure are closely related to the onset of LCPD. […] In a retrospective analysis by Swedish scholars of 852 LCPD patients, maternal tobacco exposure during pregnancy was found to significantly increase the risk of LCPD in offspring. […] Recent studies suggest that endothelial cell structural or functional abnormalities exist in LCPD patients. […] This hypothesis is supported by epidemiological and clinical examinations. […] The interruption of blood supply to the femoral head epiphysis is an established mechanism of LCPD, but research has largely focused on extravascular factors, with little emphasis on the functional state of the vessels themselves. […] This result suggests that vascular dysfunction may be prevalent among LCPD patients.

• #57 Legg–Calvé–Perthes disease – Wikipedia

  https://en.wikipedia.org/wiki/Legg%E2%80%93Calv%C3%A9%E2%80%93Perthes_disease

  The UK incidence rates show an intriguing pattern with low incidence rates in London, and a progressive increase in disease in more northerly areas (maximal in Scotland). […] Some evidence suggests, at least in developed countries, more socioeconomically deprived communities have a greater risk of disease (a similar trend to diseases such as adult heart disease), though the reason for this remains unknown. […] One possible explanation that has been considered is tobacco smoke exposure, though this is significantly confounded by the strong socioeconomic gradient common to both smoking and Perthes’ disease.

• #58

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Epidemiology […] Incidence […] affects 1 in 10,000 children […] Demographics […] 4-8 years is most common age of presentation […] male to female ratio is 5:1 […] higher incidence in urban areas […] higher among lower socioeconomic class […] higher incidence in high latitude (low incidence around equator) […] Caucasian East Asian and African American […] Anatomic location […] bilateral in 12% […] asymmetrical, asynchronous involvement […] rarely at the same stage of disease […] symmetrical involvement suggests MED (multiple epiphyseal dysplasia) […] Risk factors […] positive family history […] low birth weight […] abnormal birth presentation […] second hand smoke […] Asian, Inuit, and Central European descent […] false

• #59 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  Legg-Calve-Perthes disease (LCPD) is a known childhood form of idiopathic femoral head osteonecrosis. […] In most cases, LCPD appears in a sporadic form. Occurrences of cases in families have also been reported, with some families having more than two affected individuals. […] The incidence of LCPD varies in different geographical regions. Overall, analysis of data from 16 countries has shown that the incidence of the disease ranges from 0.2 per 100,000 to 19.1 per 100,000. […] It has also been observed that children from families of low socioeconomic status may have high incidence and are, therefore, disproportionately affected. […] A large nationwide Swedish study found an association between suboptimal birth characteristics and breech presentation during delivery with the development of LCPD.

• #60 The association between attention deficit hyperactivity disorder and Legg–Calvé–Perthes disease in tertiary hospital-Riyadh City, Saudi Arabia – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/the-association-between-attention-deficit-hyperactivity-disorder-and-legg-calv-perthes-disease-in-tertiary-hospital-riyadh-city-saudi-arabia/

  The correlation between ADHD and LCPD is not a new one; in fact, this possible relation has been addressed in several studies that have highlighted the increased incidence of ADHD among LCPD patients. […] For example, in 2014, a study conducted in Sweden by Hailer and Nilsson, which compared 4057 individuals with LCPD to a matched sex, age, and region control group of 40570 individuals without LCPD, reported a 1.5-fold higher risk of ADHD in LCPD group compared to their sex- and age-matched individuals without LCPD. […] An older study by Loder et al., reported a 33% incidence of ADHD among LCPD patients compared to 3%5% in normal population, they also suggested a correlation between ADHD and LCPD in regard to certain epidemiological factors, which were similar between the two disorders.

• #61 The association between attention deficit hyperactivity disorder and Legg–Calvé–Perthes disease in tertiary hospital-Riyadh City, Saudi Arabia – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/the-association-between-attention-deficit-hyperactivity-disorder-and-legg-calv-perthes-disease-in-tertiary-hospital-riyadh-city-saudi-arabia/

  The correlation between ADHD and LCPD is not a new one; in fact, this possible relation has been addressed in several studies that have highlighted the increased incidence of ADHD among LCPD patients. […] For example, in 2014, a study conducted in Sweden by Hailer and Nilsson, which compared 4057 individuals with LCPD to a matched sex, age, and region control group of 40570 individuals without LCPD, reported a 1.5-fold higher risk of ADHD in LCPD group compared to their sex- and age-matched individuals without LCPD. […] An older study by Loder et al., reported a 33% incidence of ADHD among LCPD patients compared to 3%5% in normal population, they also suggested a correlation between ADHD and LCPD in regard to certain epidemiological factors, which were similar between the two disorders.

• #62 The association between attention deficit hyperactivity disorder and Legg–Calvé–Perthes disease in tertiary hospital-Riyadh City, Saudi Arabia – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/the-association-between-attention-deficit-hyperactivity-disorder-and-legg-calv-perthes-disease-in-tertiary-hospital-riyadh-city-saudi-arabia/

  However, these two conclusions were different from ours, which showed a difference that was not significant between the two groups (control and case groups) regarding ADHD incidence, although the incidence in our case group was almost similar to their LCPD patients’ incidence (30% vs. 33%) and it was almost 1.5 times higher as it was 30% in the case group compared to 19% in the control group similar to the Swedish study. […] Our results showed a male predominance in the case group (78%), which is strongly consistent with the gender predominance of the reported LCPD demographical studies.

• #63 Legg-Calve-Perthes Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1248267-overview

  LCPD usually occurs in children aged 4-10 years (mean age, 7 y). It occurs more commonly in boys than in girls (male-to-female ratio, 4:1). The condition is rare, occurring in approximately 4 of 100,000 children. A British study reported an incidence of 2.8 per 100,000 persons aged 14 years or younger. […] A population-based design study demonstrated that patients with a history of LCPD seem to have a higher risk of severe injury than those without the disease. This risk may be due to a tendency for more hyperactive behavior among LCPD patients, especially females.

• #64 The epidemiology and demographics of legg-calvé-perthes’ disease. | Read by QxMD

  https://read.qxmd.com/read/24977062/the-epidemiology-and-demographics-of-legg-calv-perthes-disease

  The etiology of Legg-Calv-Perthes’ disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children 15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. The typical age at presentation ranges from 4 to 8 years (average 6.5 years), except for children from the Indian subcontinent (average 9.5 years). […] There is a mild familial component. […] LCPD can be associated with abnormalities in the coagulation cascade, including an increase in factor V Leiden mutation, low levels of protein C and/or S, and decreased antithrombin activity. […] Children with LCPD are active and score abnormally in certain standardized psychological tests.

• #65 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  A strong correlation has also been described with maternal smoking as well as exposure to second-hand smoke. […] Moreover, high rates of obesity and hypertension were also identified in a group of children having LCPD. […] The cause of the LCPD is largely unknown, though, many experimental and clinical studies provide support to the idea that the temporary disruption of the blood supply to the femoral head is a key event in the pathogenesis of the disease. […] The underlying cause may be disruption of supply of blood to the femoral epiphysis due to trauma, coagulopathy, or the use of steroids. […] The two processes have been suggested to play an essential role in the pathogenesis of osteonecrosis. […] This is supported by the fact that thrombophilia and some forms of coagulopathy are present in approximately 50% and 75% of the LCPD patients, respectively.

• #66 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  A strong correlation has also been described with maternal smoking as well as exposure to second-hand smoke. […] Moreover, high rates of obesity and hypertension were also identified in a group of children having LCPD. […] The cause of the LCPD is largely unknown, though, many experimental and clinical studies provide support to the idea that the temporary disruption of the blood supply to the femoral head is a key event in the pathogenesis of the disease. […] The underlying cause may be disruption of supply of blood to the femoral epiphysis due to trauma, coagulopathy, or the use of steroids. […] The two processes have been suggested to play an essential role in the pathogenesis of osteonecrosis. […] This is supported by the fact that thrombophilia and some forms of coagulopathy are present in approximately 50% and 75% of the LCPD patients, respectively.

• #67 Clinical and genetic characteristics of Legg-Calve-Perthes disease – Journal of Musculoskeletal Surgery and Research

  https://journalmsr.com/clinical-and-genetic-characteristics-of-legg-calve-perthes-disease/

  A high risk of LCPD is statistically significant with decreasing levels of protein C and a high risk of LCPD is nearly significant with decreasing levels of protein S was found. […] Therefore, it was concluded that the thrombophilic state due to abnormalities of the coagulation system plays a role in the LCPD. […] While some studies have found an increased rate of abnormalities of coagulation in the patients with LCPD, others have not found any association at all. […] The discrepancy might be due to some confounding factors, including a small sample size in some studies, the retrospective study design, use of suboptimal controls, and non-standardized range of laboratory values for coagulation factor level. […] A recent study has shown the incidence of 2.5% in first-degree relatives of LCPD index cases.

• #68 Frontiers | Progress in understanding Legg–Calvé–Perthes disease etiology from a molecular and cellular biology perspective

  https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1514302/full

  The etiology of LCPD was fully elaborated by Rodríguez-Olivas et al. (2022), who suggested that LCPD may be correlated with factors such as the environment, race, and coagulation. […] In recent years, significant progress has been made in etiological research on LCPD. […] The mainstream view holds that maternal passive smoking and/or postnatal infant tobacco exposure are closely related to the onset of LCPD. […] In a retrospective analysis by Swedish scholars of 852 LCPD patients, maternal tobacco exposure during pregnancy was found to significantly increase the risk of LCPD in offspring. […] Recent studies suggest that endothelial cell structural or functional abnormalities exist in LCPD patients. […] This hypothesis is supported by epidemiological and clinical examinations. […] The interruption of blood supply to the femoral head epiphysis is an established mechanism of LCPD, but research has largely focused on extravascular factors, with little emphasis on the functional state of the vessels themselves. […] This result suggests that vascular dysfunction may be prevalent among LCPD patients.

• #69

  https://journals.lww.com/jbjsjopa/fulltext/2024/09000/diagnosis_and_management_of_legg_calv__perthes.4.aspx

  Legg-Calv-Perthes disease (LCPD) is a condition marked by temporary blood flow disruption to the proximal femur, commonly afflicting children aged 15 years and younger. […] Obesity exacerbates LCPD, correlating with delayed diagnosis, increased disease severity, and bilateral involvement. […] Since 2010, there has been a steady increase in the number of overweight and obese children in the United States, with an incidence reaching 19.7% in the year 2020. […] In fact, one study showed LCPD is twice as common in the obese population compared with healthy weight children. […] Obesity has been shown to affect the progression and presentation of LCPD; however, the mechanisms by which obesity influences disease development are not well understood. […] Obesity greatly amplifies the classic presentation and prevalence of LCPD.

• #70

  https://journals.lww.com/jbjsjopa/fulltext/2024/09000/diagnosis_and_management_of_legg_calv__perthes.4.aspx

  Compared with their healthy weight counterparts, obese and overweight children are diagnosed at Waldenstrom stage 3, whereas healthy weight children are most commonly diagnosed at stage 1 or 2. […] The increased endocrine influence and higher likelihood of developing bilateral necrosis further exacerbate the severity of the disease. […] LCPD has a tendency to be diagnosed at a later stage in obese individuals, leaving the patient with permanent gait abnormalities and limited treatment options. […] Understanding the impact obesity can have on LCPD presentation and progression will aid in early diagnosis to decrease long-term complications.

• #71

  https://journals.lww.com/jbjsjopa/fulltext/2024/09000/diagnosis_and_management_of_legg_calv__perthes.4.aspx

  Compared with their healthy weight counterparts, obese and overweight children are diagnosed at Waldenstrom stage 3, whereas healthy weight children are most commonly diagnosed at stage 1 or 2. […] The increased endocrine influence and higher likelihood of developing bilateral necrosis further exacerbate the severity of the disease. […] LCPD has a tendency to be diagnosed at a later stage in obese individuals, leaving the patient with permanent gait abnormalities and limited treatment options. […] Understanding the impact obesity can have on LCPD presentation and progression will aid in early diagnosis to decrease long-term complications.

• #72

  https://journals.lww.com/jbjsjopa/fulltext/2024/09000/diagnosis_and_management_of_legg_calv__perthes.4.aspx

  Compared with their healthy weight counterparts, obese and overweight children are diagnosed at Waldenstrom stage 3, whereas healthy weight children are most commonly diagnosed at stage 1 or 2. […] The increased endocrine influence and higher likelihood of developing bilateral necrosis further exacerbate the severity of the disease. […] LCPD has a tendency to be diagnosed at a later stage in obese individuals, leaving the patient with permanent gait abnormalities and limited treatment options. […] Understanding the impact obesity can have on LCPD presentation and progression will aid in early diagnosis to decrease long-term complications.

• #73

  https://journals.lww.com/pedorthopaedics/Fulltext/2017/04000/The_Declining_Incidence_of_Legg_Calve_Perthes_.10.aspx?generateEpub=Article%7Cpedorthopaedics:2017:04000:00010%7C%7C

  Legg-Calve-Perthes disease (LCPD) is an idiopathic disease of the femoral head affecting the pediatric population. Research has demonstrated wide geographical variation in the incidence rates of LCPD with a relatively high incidence occurring in Northern Ireland (NI) shown in a previous study of incidence from the same unit. The number of new diagnoses of LCPD seems to be declining over time. This study aimed to track changes in the incidence of LCPD within the 0- to 14-year-old population over a 15-year period in NI. […] The results of this epidemiological study have demonstrated a 61% decrease in the incidence of LCPD over a 15-year period within the pediatric population of NI. […] The number of new cases of LCPD is decreasing over time. The epidemiological data are unchanged between 2 cohorts over a 15-year period, and this therefore supports a change within the patients environment relating to this decline.

• #74

  https://journals.lww.com/pedorthopaedics/Fulltext/2017/04000/The_Declining_Incidence_of_Legg_Calve_Perthes_.10.aspx?generateEpub=Article%7Cpedorthopaedics:2017:04000:00010%7C%7C

  Legg-Calve-Perthes disease (LCPD) is an idiopathic disease of the femoral head affecting the pediatric population. Research has demonstrated wide geographical variation in the incidence rates of LCPD with a relatively high incidence occurring in Northern Ireland (NI) shown in a previous study of incidence from the same unit. The number of new diagnoses of LCPD seems to be declining over time. This study aimed to track changes in the incidence of LCPD within the 0- to 14-year-old population over a 15-year period in NI. […] The results of this epidemiological study have demonstrated a 61% decrease in the incidence of LCPD over a 15-year period within the pediatric population of NI. […] The number of new cases of LCPD is decreasing over time. The epidemiological data are unchanged between 2 cohorts over a 15-year period, and this therefore supports a change within the patients environment relating to this decline.

• #75 The British Orthopaedic Surgery Surveillance study: Perthes’ disease | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.104B4.BJJ-2021-1708.R1

  The epidemiology of disease within our cohort is similar to that known, such that the disease principally affects White boys from Northern England. […] However, the incidence in our study is lower than that previously reported, and may be an underestimate of the true incidence, or may reflect a decline in frequency which has been previously observed.

• #76 Aetiology of Legg-Calvé-Perthes disease: A systematic review

  https://www.wjgnet.com/2218-5836/full/v10/i3/145.htm

  Legg-Calv-Perthes disease (LCPD) is a clinical condition affecting the femoral head of children during their growth. Its prevalence is set to be between 0.4/100000 to 29.0/100000 children less than 15 years of age with a peak of incidence in children aged from 4 years to 8 years. […] A high profile epidemiological study held in 2017 involving 2.1 million individuals attempted to report a more accurate prevalence of this disease. An overall prevalence of 9.3 per 100000 subjects was found. The male/female ratio was 3.1:1. Even though the study was conducted in Sweden from 1973 to 1993, it is one of the most up-to-date sources of evidence of LCPD epidemiology. […] The literature available on the aetiology of LCPD presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although a lot of studies focused on the genetic, biomechanical and radiological background of the disease, there is a lack of consensus on one or multiple major actors of the etiopathogenesis. More studies are needed to understand the complex and multifactorial genesis of the avascular necrosis characterizing the disease.

• #77 Legg–Calvé–Perthes disease overview | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02275-z

  LeggCalvPerthes Disease (LCPD) is a necrosis of the femoral head which affects the range of motion of the hips. Its incidence is variable, ranging from 0.4/100,000 to 29.0/ 100,000 children. […] The incidence of LCPD varies widely among countries, cities and races ranging from 0.4/100,000 to 29.0/100,000 children. LCPD usually appears from the age of 3 to 12 years old, with the highest rate of occurrence at the age of 5 to 7 years old. Boys are affected three to five times as often as girls, and the disorder is bilateral in 10-24% of patients, with a correlation to inheritance in approximately 8-12% of patients. […] Although LCPD was first described in the beginning of the past century and has been studied for more than 100 years, limited is known about its etiology. […] The cause of LCPD is unknown. Different etiologies have been proposed; nevertheless, LCPD may be caused by multiple etiologic factors that share a common final pathogenic pathway. A new perspective is that LCPD is a multifactorial disease caused by a combination of environmental, metabolic and genetic factors.

• #78 Interactive Journal of Medical Research – Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

  https://www.i-jmr.org/2021/2/e27075/

  Legg-Calv-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. […] The disease has a poor prognosis in children over 8 years old, but this group of patients can also benefit from advanced surgical methods. […] The prevalence of the disease is higher in boys than in girls. […] Current literature suggests that between 30% and 50% of children affected by LCPD will experience hip symptoms in adulthood. […] The incidence rate is between 0.2 and 19.1 per 100,000 people. […] The first presenting complaint is limping, and the second common complaint is pain, which occurs mostly in the anterior hip and medial thigh. […] The treatment of Perthes disease depends on the age and stage of presentation.

• #79 Legg-Calve-Perthes Disease | PM&R KnowledgeNow

  https://now.aapmr.org/legg-calve-perthe-disease/

  The disease affects children between ages 3 and 12 with a peak incidence between ages 5 and 7. LCPD is a rare, afflicting 1 in 1200 children. The male to female ratio is 4 to 5:1; most commonly unilateral with 10-24% of cases are bilateral. The disease is much more common in Caucasian children with declining incidence in Asian and African American populations. There is a significant geographic variation among countries. Equatorial regions have a low incidence of the disease, whereas Northern Europe has the highest documented incidence. Risk factors include exposure to secondhand smoke, hyperactive behavior, and children small for their age. […] The imaging study for the diagnosis and surveillance of LCPD is an anterior-posterior and lateral pelvis radiograph. It is important to assess the integrity and shape of the FH using the above-mentioned four stages. If early film is negative and the symptoms are recent, the radiograph should be repeated in one month. The gold standard is dynamic contrast enhanced subtraction MRI as it better delineates blood flow to the FH for early ischemia detection, correlates well with bone scintigraphy, provides prognostic value with physeal involvement and is more sensitive than radiography.

• #80 Legg-Calve-Perthes Disease | PM&R KnowledgeNow

  https://now.aapmr.org/legg-calve-perthe-disease/

  The disease affects children between ages 3 and 12 with a peak incidence between ages 5 and 7. LCPD is a rare, afflicting 1 in 1200 children. The male to female ratio is 4 to 5:1; most commonly unilateral with 10-24% of cases are bilateral. The disease is much more common in Caucasian children with declining incidence in Asian and African American populations. There is a significant geographic variation among countries. Equatorial regions have a low incidence of the disease, whereas Northern Europe has the highest documented incidence. Risk factors include exposure to secondhand smoke, hyperactive behavior, and children small for their age. […] The imaging study for the diagnosis and surveillance of LCPD is an anterior-posterior and lateral pelvis radiograph. It is important to assess the integrity and shape of the FH using the above-mentioned four stages. If early film is negative and the symptoms are recent, the radiograph should be repeated in one month. The gold standard is dynamic contrast enhanced subtraction MRI as it better delineates blood flow to the FH for early ischemia detection, correlates well with bone scintigraphy, provides prognostic value with physeal involvement and is more sensitive than radiography.

• #81 Frontiers | Progress in understanding Legg–Calvé–Perthes disease etiology from a molecular and cellular biology perspective

  https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1514302/full

  The etiology of LCPD was fully elaborated by Rodríguez-Olivas et al. (2022), who suggested that LCPD may be correlated with factors such as the environment, race, and coagulation. […] In recent years, significant progress has been made in etiological research on LCPD. […] The mainstream view holds that maternal passive smoking and/or postnatal infant tobacco exposure are closely related to the onset of LCPD. […] In a retrospective analysis by Swedish scholars of 852 LCPD patients, maternal tobacco exposure during pregnancy was found to significantly increase the risk of LCPD in offspring. […] Recent studies suggest that endothelial cell structural or functional abnormalities exist in LCPD patients. […] This hypothesis is supported by epidemiological and clinical examinations. […] The interruption of blood supply to the femoral head epiphysis is an established mechanism of LCPD, but research has largely focused on extravascular factors, with little emphasis on the functional state of the vessels themselves. […] This result suggests that vascular dysfunction may be prevalent among LCPD patients.

• #82 Legg-Calvé-Perthes Disease and Its Physiotherapy – “If the Hip Melts Away”

  https://www.heraldopenaccess.us/openaccess/legg-calv-perthes-disease-and-its-physiotherapy-if-the-hip-melts-away

  Legg-Calv-Perthes disease (or Perthes disease) is a disorder of the hip, which is caused by a vascular disorder ischemia of the femoral head and passes through four stages. It affects mostly infants and children of caucasian population. […] The incidence of the disease in the Caucasian population is 8.8 per 100,000 children and adolescents (0-15 years of age) per year. In the Asian population it is 1.0 per 100,000 per year and in the black population it is 0.4. Boys are four times more affected than girls. […] Currently it is being tested in various centers, whether an early MRI-diagnosis and early surgical indication have clinical advantages instead of X-rays. […] The Herring classification has proven to be the best method in the last years. […] Many long-term studies have verified this.

• #83 Legg-Calvé-Perthes Disease and Its Physiotherapy – “If the Hip Melts Away”

  https://www.heraldopenaccess.us/openaccess/legg-calv-perthes-disease-and-its-physiotherapy-if-the-hip-melts-away

  Legg-Calv-Perthes disease (or Perthes disease) is a disorder of the hip, which is caused by a vascular disorder ischemia of the femoral head and passes through four stages. It affects mostly infants and children of caucasian population. […] The incidence of the disease in the Caucasian population is 8.8 per 100,000 children and adolescents (0-15 years of age) per year. In the Asian population it is 1.0 per 100,000 per year and in the black population it is 0.4. Boys are four times more affected than girls. […] Currently it is being tested in various centers, whether an early MRI-diagnosis and early surgical indication have clinical advantages instead of X-rays. […] The Herring classification has proven to be the best method in the last years. […] Many long-term studies have verified this.

• #84 Interactive Journal of Medical Research – Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

  https://www.i-jmr.org/2021/2/e27075/

  The optimal treatment technique for LCPD and its prognosis are still not fully understood. […] In a large prospective review by Wiig et al, it was suggested that children aged 6 years or older, with more than 50% femoral head involvement (Catterall), had a better result if treated with surgery. […] The main goal of surgical methods is to contain the femoral head within the acetabulum in order to avoid femoral head deformation and subsequent premature hip osteoarthritis. […] A comprehensive review by Braito et al stated that femoral osteotomies were reportedly more frequent than pelvic osteotomies in the screened literature. […] The combined Salter and proximal femoral varus osteotomy for LCPD has been performed more recently. […] Triple innominate osteotomy is anticipated to show better femoral head containment than can be achieved with Salter osteotomy alone and to avoid the leg length discrepancy associated with femoral varus osteotomy.

• #85 Interactive Journal of Medical Research – Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

  https://www.i-jmr.org/2021/2/e27075/

  The optimal treatment technique for LCPD and its prognosis are still not fully understood. […] In a large prospective review by Wiig et al, it was suggested that children aged 6 years or older, with more than 50% femoral head involvement (Catterall), had a better result if treated with surgery. […] The main goal of surgical methods is to contain the femoral head within the acetabulum in order to avoid femoral head deformation and subsequent premature hip osteoarthritis. […] A comprehensive review by Braito et al stated that femoral osteotomies were reportedly more frequent than pelvic osteotomies in the screened literature. […] The combined Salter and proximal femoral varus osteotomy for LCPD has been performed more recently. […] Triple innominate osteotomy is anticipated to show better femoral head containment than can be achieved with Salter osteotomy alone and to avoid the leg length discrepancy associated with femoral varus osteotomy.

• #86 A systematic review of the non-surgical treatment of Perthes’ disease | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/2633-1462.112.BJO-2020-0138.R1

  Perthes disease is a condition leading to necrosis of the femoral head. It is most common in children aged four to nine years, affecting around one per 1,200 children in the UK. […] Given the life-long impact of Perthes disease, the British Society for Childrens Orthopaedic Surgery (BSCOS) consensus exercise, and a separate James Lind Alliance Priority Setting Partnership, have identified Perthes disease management as one of the highest priorities for research. […] Evidence from non-randomized studies found no robust evidence regarding the most effective non-surgical interventions for the treatment of children with Perthes disease. Future research, employing randomized trial designs, and reporting a wider range of patient outcomes is urgently needed to inform clinical practice. […] The aim of this review was to evaluate the use of any non-surgical treatment for Perthes disease, seeking comparisons to other surgical or non-surgical interventions.

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