Legg-Calvé-Perthes Disease and Slipped Capital Femoral Epiphysis

Legg-Calvé-Perthes disease happens when the blood supply to the rounded top of the thigh bone is reduced for a time. The bone can weaken, change shape, and then gradually heal. The process may cause hip, groin, thigh, or knee discomfort and a limp, sometimes with stiffness or reduced hip movement.

Slipped capital femoral epiphysis, also called SCFE or a slipped growth plate of the hip, occurs when the upper thigh bone shifts at the growth plate near the hip. It can develop gradually or follow a sudden increase in pain. A child may describe pain in the hip, groin, thigh, or knee; the leg may turn outward, and walking can become difficult. The symptom pattern overlaps, so an examination and hip imaging are needed to tell them apart.

Arrange an assessment with a paediatrician or orthopaedic clinician when a child has an unexplained limp, recurring hip or knee pain, stiffness, or a change in the way the leg moves. Until reviewed, reduce running, jumping, and sports; use support when walking if needed, and follow the clinician's advice about pain relief. Do not force stretches or weight-bearing through marked pain.

Treatment depends on the condition, its stage, the child's growth, and how stable the hip is. Care may include activity limits, physiotherapy to preserve movement, crutches, or surgery. A stable or unstable SCFE is managed urgently by an orthopaedic team, often to prevent further slipping. Perthes care may involve monitoring hip shape and movement over time, with treatment selected to keep the ball of the hip well positioned.

Seek urgent medical care if a child suddenly cannot put weight on the leg, has severe or rapidly worsening hip pain, or develops pain after a fall or other injury. Fever, a hot or swollen joint, or a child who looks acutely unwell also needs prompt assessment because infection and injury can require immediate treatment. Keep the child off the leg while arranging help if walking is very painful.

Do not wait for pain to settle when a child has a new limp with hip, thigh, or knee pain. SCFE can worsen with continued weight-bearing, while early assessment of Perthes disease helps the team plan movement and protect the developing joint.

Ask which diagnosis is suspected, whether both hips need imaging, and whether the child should use crutches or avoid weight-bearing. You can also ask which movements are safe, how physiotherapy will be monitored, what changes should trigger urgent review, and how follow-up will track the growth and shape of the hip.