The Irritable hip

Royle, S. G.; Galasko, C. S. B.

doi:10.3109/17453679209154843

Cited by 22 publications

(2 citation statements)

References 16 publications

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“…The necessity of high and prolonged pressure, which is difficult to achieve in normal conditions, was reported. Several research studies reported evidence of ischemia damage using radiological techniques[60-64]. This provides evidence of its role in the enteropathogenesis of the LCPD.…”

Section: Resultsmentioning

confidence: 92%

Aetiology of Legg-Calvé-Perthes disease: A systematic review

Pavone

Chisari

Vescio

et al. 2019

WJO

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BACKGROUNDLegg-Calvé-Perthes disease (LCPD) is a clinical condition affecting the femoral head of children during their growth. Its prevalence is set to be between 0.4/100000 to 29.0/100000 children less than 15 years of age with a peak of incidence in children aged from 4 years to 8 years. LCPD aetiology has been widely studied, but it is still poorly understood.AIMTo analyse the available literature to document the up-to-date evidence on LCPD aetiology.METHODSA systematic review of the literature was performed regarding LCPD aetiology, using the following inclusion criteria: studies of any level of evidence, reporting clinical or preclinical results and dealing with the aetiology or pathogenesis of LCPD. Two reviewers searched the PubMed and Science Direct databases from their date of inception to the 20th of May 2018 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. To achieve the maximum sensitivity of the search strategy, we combined the terms: ‘‘Perthes disease OR LCPD OR children avascular femoral head necrosis” with “pathology OR aetiology OR biomechanics OR genetics” as either key words or MeSH terms.RESULTSWe include 64 articles in this review. The available evidence on LCPD aetiology is still debated. Several hypotheses have been researched, but none of them was found decisive. While emerging evidence showed the role of environmental risk factors and evidence from twin studies did not support a major role for genetic factors, a congenital or acquired predisposition cannot be excluded in disease pathogenesis. One of the most supported theories involved mechanical induced ischemia that evolved into avascular necrosis of the femoral head in sensible patients.CONCLUSIONThe literature available on the aetiology of LCPD presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although a lot of studies focused on the genetic, biomechanical and radiological background of the disease, there is a lack of consensus on one or multiple major actors of the etiopathogenesis. More studies are needed to understand the complex and multifactorial genesis of the avascular necrosis characterizing the disease.

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Section: Resultsmentioning

confidence: 92%

Aetiology of Legg-Calvé-Perthes disease: A systematic review

Pavone

Chisari

Vescio

et al. 2019

WJO

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“…If limited range of motion is important, a few days of traction might be indicated. We advocate an X-ray control after 6 to 8 weeks to exclude LCPD, which sometimes shows similar early symptoms [8].…”

Section: Transient Synovitis or Irritable Hipmentioning

confidence: 99%

Clinical practice

Fabry¹

2009

Eur J Pediatr

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Hip problems in children are relatively rare but usually serious, potentially causing lifelong disability. Early diagnosis and treatment is, therefore, mandatory. The aim of this review is to discuss the most frequent diseases of the hip from birth to adolescence. The different affections are relatively closely related to age periods. After birth and in infancy, developmental dislocation of the hip (DDH) and septic arthritis are more prominent. DDH is not always present at birth and should regularly be checked for in the first 6 months of life. Septic arthritis is an emergency and should be adequately treated within 4 days of the beginning of the infection with open drainage of the hip. Transient synovitis and Legg-Calvé-Perthes disease (LCPD) are mostly found between 4 and 10 years of age. Transient synovitis is the most frequent hip disorder in that age group. It is a self-limiting noninfectious effusion in the joint without serious consequences. Differential diagnosis with septic arthritis should, however, be made. LCPD is an idiopathic avascular necrosis of the hip causing flattening and deformity of the femoral head, depending on the extent of the necrosis. Treatment by containment is aimed at favoring the remodeling of the deformed femoral head. Finally, between the age of 10 and 15 years, slipped capital femoral epiphysis (SCFE) should be the preferential diagnosis, especially in the limping obese boy. SCFE is an inferior and posterior displacement of the proximal epiphysis of the femur in the growth plate. It should be treated as an emergency with a screw fixation.

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Morbus Perthes

Kinderorthopädie in Der Praxis

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The Irritable hip

Cited by 22 publications

References 16 publications

Aetiology of Legg-Calvé-Perthes disease: A systematic review

Aetiology of Legg-Calvé-Perthes disease: A systematic review

Clinical practice

Morbus Perthes

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