Legg-Calve-Perthes disease typically presents with which symptom?

Legg-Calve-Perthes disease typically presents with which symptom?

• A. Knee pain in a child with a painless limp
• B. Intermittent hip or groin pain
• C. Normal hip exam with full range of motion
• D. Fever and malaise

Answer: (C)

Legg-Calve-Perthes disease is a pediatric avascular necrosis of the femoral head that most often shows up as an insidious limp with hip or groin pain. The pain is typically in the hip region and can be felt as intermittent rather than constant; it may even be referred to the knee. On examination, you’d expect some loss of hip motion, especially internal rotation and abduction, even if the child can still flex the hip fairly well early on. A fever or systemic symptoms would be unusual, pointing away from an infectious process. A hip exam that is completely normal with full range of motion would not fit typical Perthes timing, since there is usually at least some limitation of motion as the disease progresses.

Legg-Calve-Perthes disease is a pediatric avascular necrosis of the femoral head that most often shows up as an insidious limp with hip or groin pain. The pain is typically in the hip region and can be felt as intermittent rather than constant; it may even be referred to the knee. On examination, you’d expect some loss of hip motion, especially internal rotation and abduction, even if the child can still flex the hip fairly well early on. A fever or systemic symptoms would be unusual, pointing away from an infectious process. A hip exam that is completely normal with full range of motion would not fit typical Perthes timing, since there is usually at least some limitation of motion as the disease progresses.