Legg-Calve-Perthes Disease in Emergency Medicine Medication
- Author: Geofrey Nochimson, MD; Chief Editor: Rick Kulkarni, MD more...
Medication Summary
Medical treatment does not stop or reverse the bony changes. Appropriate analgesic medication should be given.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Class Summary
These drugs most commonly are used for the relief of mild to moderately severe pain. Although the effects of NSAIDs in the treatment of pain tend to be patient specific, ibuprofen is usually the drug of choice (DOC) for the initial therapy.
Ibuprofen (Advil, Motrin, Nuprin)
Usually DOC for treatment of mild to moderately severe pain if no contraindications. Inhibits inflammatory reactions and pain, probably by decreasing activity of enzyme cyclooxygenase, thus decreasing prostaglandin synthesis.
Acetaminophen (Tylenol, Panadol, Aspirin-Free Anacin)
DOC for treatment of pain in patients with documented hypersensitivity to aspirin and NSAIDs, as well as those with upper GI disease or who are taking oral anticoagulants.
Kim HK. Legg-Calve-Perthes disease. J Am Acad Orthop Surg. Nov 2010;18(11):676-86. [Medline].
Sharma S, Shewale S, Sibinski M, Sherlock DA. Legg-Calve-Perthes disease affecting children less than eight years of age: a paired outcome study. Int Orthop. Feb 2009;33(1):231-5. [Medline].
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. Oct 2008;90(10):1364-71. [Medline].
Boss JH, Misselevich I. Osteonecrosis of the femoral head of laboratory animals: the lessons learned from a comparative study of osteonecrosis in man and experimental animals. Vet Pathol. Jul 2003;40(4):345-54. [Medline].
Epidemiology of Perthes' disease. Arch Dis Child. May 2000;82(5):385. [Medline].
Erkula G, Bursal A, Okan E. False profile radiography for the evaluation of Legg-Calve-Perthes disease. J Pediatr Orthop B. Jul 2004;13(4):238-43. [Medline].
Frick SL. Evaluation of the child who has hip pain. Orthop Clin North Am. Apr 2006;37(2):133-40, v. [Medline].
Herring JA. The treatment of Legg-Calve-Perthes disease. A critical review of the literature. J Bone Joint Surg Am. Mar 1994;76(3):448-58. [Medline].
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. Oct 2004;86-A(10):2103-20. [Medline].
Jacobs R, Moens P, Fabry G. Lateral shelf acetabuloplasty in the early stage of Legg-Calve-Perthes disease with special emphasis on the remaining growth of the acetabulum: a preliminary report. J Pediatr Orthop B. Jan 2004;13(1):21-8. [Medline].
Kamegaya M, Saisu T, Ochiai N, Hisamitsu J, Moriya H. A paired study of Perthes' disease comparing conservative and surgical treatment. J Bone Joint Surg Br. Nov 2004;86(8):1176-81. [Medline].
Kaniklides C. Diagnostic radiology in Legg-Calve-Perthes disease. Acta Radiol Suppl. 1996;406:1-28. [Medline].
Kaniklides C, Lonnerholm T, Moberg A. Legg-Calve-Perthes disease. Comparison of conventional radiography, MR imaging, bone scintigraphy and arthrography. Acta Radiol. Jul 1995;36(4):434-9. [Medline].
Kim HK. Legg-Calve-Perthes disease. J Am Acad Orthop Surg. Nov 2010;18(11):676-86. [Medline].
Molloy MK, MacMahon B. Incidence of Legg-Perthes disease (osteochondritis deformans). N Engl J Med. Nov 3 1966;275(18):988-90. [Medline].
Poul J. Diagnosis of Legg-Calve-Perthes disease. Ortop Traumatol Rehabil. Oct 30 2004;6(5):604-6. [Medline].
Roy DR. Current concepts in Legg-Calve-Perthes disease. Pediatr Ann. Dec 1999;28(12):748-52. [Medline].
Sinigaglia R, Bundy A, Okoro T, Gigante C, Turra S. Is conservative treatment really effective for Legg-Calve-Perthes disease? A critical review of the literature. Chir Narzadow Ruchu Ortop Pol. Nov-Dec 2007;72(6):439-43. [Medline].
Skaggs DL, Tolo VT. Legg-Calve-Perthes Disease. J Am Acad Orthop Surg. Jan 1996;4(1):9-16.
Thompson GH, Salter RB. Legg-Calve-Perthes disease. Clin Symp. 1986;38(1):2-31. [Medline].

