Legg reports five children with a previously unrecognized flattening of the femoral head. He asks whether this is a distinct condition and proposes a cause based on impaired blood supply to the head. This 1909 presentation is one of the three original descriptions that named Legg-Calvé-Perthes disease.
When a child aged 5 to 8 presents with a painless limp and no shortening, Legg-Calvé-Perthes disease belongs at the top of your differential. Legg's series captured the clinical signature that still holds: limp as the presenting complaint, minimal pain, and radiographic flattening of the femoral head with a short, thick neck.
His core mechanistic insight, that the femoral head is nourished mainly through vessels in the neck and that compromising this supply softens and flattens the epiphysis, anticipates the modern understanding of LCPD as avascular necrosis of the developing femoral head. The trauma etiology he proposed did not survive, but the vascular framework did.
One practical teaching point endures: LCPD can be bilateral and silent on one side, so image the contralateral hip and do not assume a normal-feeling hip is normal.
Legg reports five children with a previously unrecognized flattening of the femoral head. He asks whether this is a distinct condition and proposes a cause based on impaired blood supply to the head. This 1909 presentation is one of the three original descriptions that named Legg-Calvé-Perthes disease.
When a child aged 5 to 8 presents with a painless limp and no shortening, Legg-Calvé-Perthes disease belongs at the top of your differential. Legg's series captured the clinical signature that still holds: limp as the presenting complaint, minimal pain, and radiographic flattening of the femoral head with a short, thick neck.
His core mechanistic insight, that the femoral head is nourished mainly through vessels in the neck and that compromising this supply softens and flattens the epiphysis, anticipates the modern understanding of LCPD as avascular necrosis of the developing femoral head. The trauma etiology he proposed did not survive, but the vascular framework did.
One practical teaching point endures: LCPD can be bilateral and silent on one side, so image the contralateral hip and do not assume a normal-feeling hip is normal.