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Calvé-Legg-Perthes sykdom

Sist revidert:
Sist revidert av:


Definisjon:
Aseptisk nekrose, osteonekrose, av caput femoris-epifysen hos barn som følge av nedsatt blodtilførsel til dette området (avaskulær nekrose)
Forekomst:
Årsinsidens i Norge er 9 per 100.000 barn under 12-15 år
Symptomer:
Starter ofte vagt med kortvarige, forbigående episoder med halting og lite eller ingen smerte. Episodene oppstår særlig etter belastning og fysisk anstrengelse, og tiltar over tid
Funn:
Haltende gange og økende grad av bevegelsesinnskrenkning, særlig abduksjon og innoverrotasjon
Diagnostikk:
Røntgen og MR gir diagnosen
Behandling:
Symptomatisk eller kirurgisk
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  2. Chaudhry S, Phillips D, Feldman D. Legg-Calvé-Perthes disease: an overview with recent literature. Bull Hosp Jt Dis 2014; 72: 18-27. PubMed  
  3. Mazloumi SM, Ebrahimzadeh MH, Kachooei AR. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease. Arch Bone Jt Surg 2014; 2: 86-92. PubMed  
  4. Wiig O, Terjesen T, Svenningsen S, et al. The epidemiology and aetiology of Perthes’ disease in Norway. A nationwide study of 425 patients. J Bone Joint Surg Br 2006; 88: 1217-23. PubMed  
  5. Shah H. Perthes disease: evaluation and management. Orthop Clin North Am 2014; 45: 87-97. PubMed  
  6. Wiig O, Huhnstock S, Terjesen T, et al. The outcome and prognostic factors in children with bilateral Perthes' disease: a prospective study of 40 children with follow-up over five years. Bone Joint J 2016; 98-B: 569-75. doi:10.1302/0301-620X.98B4.36045 DOI  
  7. Heesakkers N, van Kempen R, Feith R, Hendriks J, Schreurs W. The long-term prognosis of Legg-Calvé-Perthes disease: a historical prospective study with a median follow-up of forty one years. Int Orthop. 2014 Nov 19.
  8. Szepesi K, Posan E, Harsfalvi J, et al. The most severe forms of Perthes' disease associated with the homozygous Factor V Leiden mutation. J Bone Joint Surg Br 2004;86:426-429. PubMed  
  9. Gordon JE, Schoenecker PL, Osland JD, et al. Smoking and socio-economic status in the etiology and severity of Legg-Calvé-Perthes' disease. J Pediatr Orthop B 2004;13:367-370. PubMed  
  10. Bahmanyar S, Montgomery SM, Weiss RJ, et al. Maternal smoking during pregnancy and other prenatal and perinatal factors and the risk of Legg-Calvé-Perthes disease. Pediatrics 2008;122:459-464. Pediatrics  
  11. Perry DC, Bruce CE, Pope D, et al. Perthes' disease of the hip: socioeconomic inequalities and the urban environment. Arch Dis Child 2012;97:1053-1057. PubMed  
  12. Herring JA, Kim HT, Browne R. Legg-Calve-Perthes disease. Part I: Classification of radiographs with use of the modified lateral pillar and Stulberg classifications. J Bone Joint Surg Am 2004; 86: 2103-20. PubMed  
  13. Wainwright A, Knight D. Legg-Calvé-Perthes' disease. BMJ Best Practice, last reviewed August 2020. bestpractice.bmj.com  
  14. Wiig O, Svenningsen S, Terjesen T. Calvé-Legg-Perthes' sykdom. Oversiktsartikkel. Tidsskr Nor Legeforen 2011; 131: 946-9. Tidsskrift for Den norske legeforening  
  15. Nguyen NA, Klein G, Dogbey G, et al. Operative versus nonoperative treatments for Legg-Calvé-Perthes disease: a meta-analysis. J Pediatr Orthop 2012;32:697-705. PubMed  
  16. Saran N, Varghese R, Mulpuri K. Do femoral or salter innominate osteotomies improve femoral head sphericity in Legg-Calvé-Perthes disease? A meta-analysis. Clin Orthop Relat Res 2012;470:2383-2393. PubMed  
  17. Karimi MT, McGarry T. A comparison of the effectiveness of surgical and nonsurgical treatment of legg-calve-perthes disease: a review of the literature. Adv Orthop. 2012. 2012:490806. PMID: 22953066. PubMed  
  18. Wiig O, Terjesen T, Svenningsen S. Prognostic factors and outcome of treatment in Perthes' disease: a prospective study of 368 patients with five-year follow-up. J Bone Joint Surg Br. 2008 Oct. 90(10):1364-71.
  • Ingard Løge, spesialist i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo
  • Stein E Høyer, overlege barneavdelingen, Regionsykehuset i Tromsø
  • Christian Wong, overlæge, ph.d., Ortopædkirurgisk afdeling, Hvidovre Hospital (Lægehåndbogen)