The presentation of Legg−Calvé−Perthes disease in females. (August 2015)

• Record Type: Journal Article
• Authors: Georgiadis, Andrew G.; Seeley, Mark A.; Yellin, Joseph L.; Sankar, Wudbhav N.
• Is Part Of: Journal of children's orthopaedics. Volume 9:Number 4(2015)
• Page Start: 243
• Page End: 247
• Publication Date: 2015-08
• Subjects: Legg−Calvé−Perthes -- Perthes disease -- Osteonecrosis femoral head -- Late presentation; Pediatric orthopedics -- Periodicals; 618.927005
• DOI: 10.1007/s11832-015-0671-y
• Languages: English
• ISSNs: 1863-2521

Abstract

Purpose: Legg−Calvé−Perthes disease (LCPD) is uncommon in girls. The presentation of LCPD in female patients has been reported as later in onset and associated with certain high-impact activities. Our aim is to characterize the presentation of female LCPD at a large center, with particular attention to the clinical and radiographic features of late-onset disease (>ten years of age). We perceived an increasing burden of late-onset disease with adult-like radiographic features. Methods: All patients presenting to a single large urban children's hospital from 1990−2014 with a diagnosis of LCPD were reviewed. Demographic, clinical, and radiographic data for all female patients were examined and compared to historical norms. Results: Four-hundred and fifty-one patients presented with LCPD in the study period, of which 82 (18.2 %) were female. The average age at presentation was 6.58 years in girls, which is similar to the classically reported mean age. Fourteen patients participated in high-impact repetitive activities or those with deep flexion and abduction, although few were late presenters. There were four female patients who presented for initial diagnosis >ten years of age. Conclusions: There was a paucity of late-onset LCPD in girls in the study population, and the females with LCPD had a very similar age and character to their presentation as did males. Although their presentation is infrequent, three of four older females with LCPD were engaged in high-level physical activity, and their disease may be attributed to high-impact, repetitive athletics. Level of evidence: Case series, Level IV.