Table of Contents
ISRN Orthopedics
Volume 2011 (2011), Article ID 504393, 14 pages
http://dx.doi.org/10.5402/2011/504393
Review Article

The Epidemiology and Demographics of Legg-Calvé-Perthes' Disease

1Section of Orthopedic Surgery, Riley Hospital for Children, ROC 4250, 705 Riley Hospital Drive, IN, Indianapolis 46202, USA
2Department of Orthopaedic Surgery, Indiana University, Indianapolis, IN 46202, USA
3Ruth Lilly Medical Library, School of Medicine, Indiana University, Indianapolis, IN 46202, USA

Received 15 May 2011; Accepted 20 June 2011

Academic Editor: S. García-Mata

Copyright © 2011 Randall T. Loder and Elaine N. Skopelja. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The etiology of Legg-Calvé-Perthes' disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children <15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. The typical age at presentation ranges from 4 to 8 years (average 6.5 years), except for children from the Indian subcontinent (average 9.5 years). There is a mild familial component. The children demonstrate impaired growth in height, skeletal age, and birth weight. This impaired growth coincides with an age appropriate reduced somatomedin A activity and decreased levels of IGF. LCPD can be associated with abnormalities in the coagulation cascade, including an increase in factor V Leiden mutation, low levels of protein C and/or S, and decreased antithrombin activity. There is decreased turnover in type I collagen and synthesis of type III collagen, as well as reduced levels of urinary glycosaminoglycans in the active phases of the disorder. Subtle abnormalities in the opposite hip and other minor/major congenital defects are reported. Children with LCPD are active and score abnormally in certain standardized psychological tests.