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Legg–Calvé–Perthes Disease (, ) is a childhood hip disorder initiated by a disruption of blood flow to the ball of the femur called the femoral head. Due to the lack of blood flow, the bone dies (osteonecrosis or avascular necrosis) and stops growing. Over time, healing occurs by new blood vessels infiltrating the dead bone and removing the necrotic bone which leads to a loss of bone mass and a weakening of the femoral head.〔Kim, HK. Pathophysiology and new strategies for the treatment of Legg-Calve-Perthes disease. Journal of Bone and Joint Surgery American 2012 volume 94 Issue 7 Pages 659-69. PMID 22488623〕 The bone loss leads to some degree of collapse and deformity of the femoral head and sometimes secondary changes to the shape of the hip socket. It is also referred to as idiopathic avascular osteonecrosis of the capital femoral epiphysis of the femoral head since the cause of the interruption of the blood supply of the head of the femur in the hip joint is unknown. The disease is most commonly found in children between the ages of 4 to 8 but it can occur in children between the ages of 2 to 15. The main long-term problem with this condition is that it can produce a permanent deformity of the femoral head which increases the risk of developing osteoarthritis in adults. It is also commonly known as Perthes Disease, Legg–Perthes Disease, or Legg–Calve–Perthes Disease (LCPD). Because Perthes' disease is associated with certain clinical features more common in boys such as hyperactivity, small stature for age, delayed bone age, and some minor congenital anomalies, some call this Legg–Calvé–Perthes Syndrome to emphasize that the disease process may not be isolated to the hip joint only. The name originated from the following people: Arthur Legg (1874-1939), an American orthopedic surgeon, Jacques Calvé (1875-1954), French orthopedic surgeon, and Georg Perthes, German orthopedic surgeon. The disease name was first described by Karel Maydl. ==Signs and symptoms== Common symptoms include hip, knee (hip pathology can refer pain to a normal knee), or groin pain, exacerbated by hip/leg movement, especially internal hip rotation (twisting the leg toward the center of the body). There is reduced range of motion, particularly in abduction and internal rotation, and the patient presents with a limp. Pain is usually mild. There may be atrophy of thigh muscles from disuse and an inequality of leg length. In some cases, some activity can cause severe irritation or inflammation of the damaged area including standing, walking, running, kneeling, or stooping repeatedly for an extended period of time. In cases exhibiting severe femoral osteonecrosis, pain is usually a chronic, throbbing sensation exacerbated by activity. The first signs are complaints of soreness from the child, which are often dismissed as growing pains, and limping or other guarding of the joint, particularly when tired. The pain is usually in the hip, but can also be felt in the knee ('referred pain'). In some cases, pain is felt in the unaffected hip and leg, due to the child favoring the injured side and placing the majority of their weight on the "good" leg. It is predominantly a disease of boys (4:1 ratio). Perthes is generally diagnosed between 5 and 12 years of age, although it has been diagnosed as early as 18 months. Typically the disease is only seen in one hip, but bilateral Perthes is seen in about 10% of children diagnosed. (The differential diagnosis for bilateral Perthes disease is Multiple Epiphyseal Dysplasia).〔(Legg-Calve-Perthes Disease Imaging ) Author: Ali Nawaz Khan. Chief Editor: Felix S Chew. Updated: May 28, 2008〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Legg–Calvé–Perthes disease」の詳細全文を読む スポンサード リンク
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