Talk:Legg–Calvé–Perthes disease

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Incidence?

In the US, 1 in 1200 children younger than 15 years will have this disease while in the UK 1 in 18,000 suffer from it.
    children 4 to 10 are more likely to be diagnosed

This seems a remarkable divergence: why is it fifteen times more common in the US than the UK? Loganberry (Talk) 03:59, 22 June 2006 (UTC)[reply]

Its not - this disparity has arisen because incidence rates are calculated poorly and widely misinterpreted. The annual incidence in the UK currently is 5.5 cases per 100,000 0-14 years olds per year (assessed by Perry et al using a number of differing databases including local and several national databases). As the denominator is 0 - 15 years this equates to a child having 15 years at risk of risk of disease (so 15 * 5.5/100,000). This means that in a childs lifetime the risk of disease is about 1:1200. The incidence in the USA is almost certainly less than the UK (certainly the Northern parts of the UK where the incidence has been demonstrated to be particularly great).The rates on an international scale were analysed (and the denominator population standardised) in a systematic review by Perry et al - 2010 Am J Epi (referenced in the main text).

There is a reference on PubMed that states that in the UK, the incidence is more likely in the range of 15.4 per 100,000, or one in 6,494. Reidweaver (talk) 17:45, 5 February 2008 (UTC)[reply]

If you have reference, it always helps if you can actually cite it. We'll need the citation if we end up using it in the article. Thanks, Bovlb (talk) 17:19, 6 February 2008 (UTC)[reply]

The website that references the incidence of perthes in the UK is http://www.jbjs.org.uk/cgi/content/abstract/87-B/11/1531 Hope that helps! Reidweaver (talk) 17:25, 6 February 2008 (UTC)[reply]

Here are references for 1 in 1200 children. 5.5 in 100k seems too rare. http://emedicine.medscape.com/article/826935-overview http://www.nonf.org/perthesbrochure/perthes-brochure.htm 

-LTB 2 Mar 10  —Preceding unsigned comment added by 99.139.144.243 (talk) 21:16, 2 March 2010 (UTC)[reply]

Bisphosphonates, A Promising Treatment

Recently, new research has been looking at the use of bisphosphonates, such as Fosamax and Actonel, for the treatment of Legg Perthes. Bisphosphonates are currently used for treating osteoporosis in adults. How it works: there are two types of bone cells, osteoblasts and osteoclasts. Osteoblasts are bone-building cells. Osteoclasts are bone cells that absorb and remove bone tissue. Through the perthes process osteoclasts are at work during fragmentation and bone is lost. Bisphosphonates stop the osteoclastic process, thereby lessening the fragmentation process and the damage caused by it. Here's an article that talks about research into the use of bisphosphonates for perthes: http://www.ejbjs.org/cgi/content/abstract/89/8/1727. I have the opportunity to talk with many pediatric orthopedics and there is encouragement from this research. Reidweaver (talk) 12:34, 12 April 2008 (UTC)[reply]

Transphyseal Neck Drilling

In Portugal, there is a pediatric orthopedist who has been studying the growing hip to determine what factors may cause perthes. He found what are called ischemic episodes which can often be evidenced by pain and upon investigation, show sporatic blood flow. These episodes are precursors to Legg Calvé Perthes. Dr. Lopes found that by inserting a very fine drill into the area, blood flow is stimulated and the episode ends. In his research, Dr. Lopes found that of the children with ischemic episodes who were drilled, none went on to develop perthes. Of the group who were not drilled, 50% developed the disease. Transphyseal neck drilling is now being done in the United States as a result of this research. http://www.geocities.com/craveiro01/pagedlcp/index.html Reidweaver (talk) 12:54, 12 April 2008 (UTC)[reply]

Some mention of platelet derived growth factors in augmenting blood flow would be interesting. ScienceDaily (Mar. 10, 2008) — Researchers have discovered a way to control the growth rate of replacement tissue and the formation of new blood vessels.Wrinkleworm (talk) 16:36, 14 August 2008 (UTC)[reply]

Genetics

In the first section says there is no evidence for it being genetic, then in a later section it says it is. —Preceding unsigned comment added by 136.8.152.13 (talk) 07:57, 27 October 2009 (UTC)[reply]

@136.8.152.13 I had it as a child and my mother's uncle had it. We had no environmental conditions in common. 107.123.21.34 (talk) 23:07, 17 February 2023 (UTC)[reply]

inherited

I am a 49 year old woman who passed this disease directly to my son. What happened I don't know I was not supposed to pass this on. I did ask my specialist if I could pass this on he said no, much to my dismay I gave this to my son. My son is now 27 starting his own family, and all I can do is pray it goes no further. —Preceding unsigned comment added by Dee dee spears (talk • contribs) 14:01, 31 October 2010 (UTC)[reply]

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Leggs-Anderson-Perthes Disease in 1966 and my experience.

--CherieMcNaul (talk) 23:38, 27 December 2019 (UTC) I was six years old when I was diagnosed with this disease in my right hip. This article is spot-on on describing the the attributes of this disease. However, the description of pain is rather minor. The pain was excruciating in doing any movement one could imagine just the act of jogging would inflict. Walking was just as painful and tiring. Even though the disease would 'run its course', it didn't take much to re-injure or effect the healing process.[reply]

The specialists at the University of Iowa Hospital and Clinics first put me on crutches and was not allowed to put any weight on my right leg whatsoever for over a year. Then they put me in what they called a 'harness'. A strap went over my right shoulder, connected to a belt that went around my waist, and a strap hung done and connected to a cuff that buckled around my right ankle. Evidence of healing of the femoral ball, pleased my doctors very much, but the discovered that my right leg bone was growing curved. To correct that, they put me in the hospital for two weeks in leg tractions, then placed me a cast that covered me from my waist and down my right leg to my toes. I spent the whole school year in that cast and wasn't removed until school let out for the summer.

I was placed back on crutches again but allowed two hours without them with limited activity. That was late summer of 1969, and declared cured. However, throughout my young life, I had relapses of the disease. I was in constant pain throughout my adult life. I went to five different orthopedic surgeons looking for one who would do a hip replacement. They all refused because of my age (too young at 29, though they were doing knee replacements for men just as young and size so they could play golf) and stature. By the fall of 2003, and suffered repeated hip dislocations and was forced to seek out an orthopedic specialist once again. By January of 2004 at the age of 44, I got my hip replacement.

The surgeon told me it was the worst misshapened hip ball he'd ever seen in his career. In description, there was very little appearance of a ball, and was shaped more like the head of a hammer. The hip replacement has given me much relief from such extreme pain, but I also have Degenerative Joint Disease throughout my body. The arthritis being the worst in my pelvis and rib cage today.

What those specialists didn't find back in 1966 was that I also had not one, but two, auto-immune disorders. Distal RTA 1-2 and Hyphochromic Microcytic Anemia. As much as chronic acidic blood and this specific anemia has ravaged my body, (I now have Stage 3 CKD that is closer to stage 4)I can't help but wonder if the LAP Disease (which they now call Avascular Necrosis)was caused by these two auto-immune disorders instead.

My name is Cheri McNaul, I live in Tulsa, OK and I am nearly 60 years old now. I never let my disability rule my life and I was paying income taxes since I was twelve years old. However the day came when I was forced into a desk job, and then was forced to give up that because sitting became too difficult to manage the physical stresses and pain.

I just wanted to commend the person who wrote this article on this debilitating disease.

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