Perthes’ disease

The Perthes’ desease or Legg-Calvé-Perthes (LCP) still remains one of the most controversial pathology in the field of pediatric orthopedic surgery. Many aspects of the disease remains still unknown or unclear, including its etiology and pathophysiology. To plan a timely treatment avoiding the degenerative pathological changes and thus clinical signs of disease, the diagnosis is fundamental in the opening phase making use of traditionalradiography and also further diagnostic techniques such as MRI and contrast-enhanced MRI. Among the several factors that may have prognostic value, the most important are in fact represented by the age of beginning of the disease and by the radiographic changes in femoral head with consequent modification of motion. The aim of treatment is to prevent the beginning of femoral head’s deformity and the incongruity of the affected hip. The choice of surgical or conservative treatment depends on patients, and it is influenced by several factors including the age of onset, radiographic evaluation, the involvement of the femoral head and the degree of limitation of the hip joint. In this work we provide an overview of current knowledge about Perthes’ disease, in the light of a selective review of the literature and our experience.