Calvé disease is also called Calvé-Legg-Perthes disease. This is because this condition or disease was discovered by three doctors, who described the symptoms almost simultaneously. This is a condition of the hip joint. Due to underlying cause (can also be hereditary), the blood supply to the femoral head is temporarily reduced. This causes the tissue in the femoral head to die. The bone dissolves and the body produces new cells. Unfortunately, this causes deformities. It occurs most often in children between 3 and 13 years old and in small breed dogs.
Calvé’s disease
In 1910, the French orthopedist Jacques Calvé discovered a condition of the hip joint that occurs in both children and dogs. But at the same time it was also the German surgeon Perthes and the American orthopedist Legg who discovered this disease or condition. That is why this disease is also called Calvé-Legg-Perthes disease. A different order in these names also occurs.
Disorder of the hip joint
The hip joint is a ball and socket joint. It consists of a cup and a bowl. The hip joint connects the pelvis and the femur and provides great mobility. When the hip joint does not work properly, complaints such as stiffness and pain arise. In Calvé’s disease we see that the blood supply to the femoral head is disrupted. This causes a deformity.
Causes
Research in dogs has shown that this disease is probably hereditary. The exact circumstances remain unknown. It is notable that this disease mainly occurs in children between 3 and 11 years old and in small dog breeds. Blood circulation is temporarily disrupted, causing the tissue of the femoral head to die. The bone slowly dissolves. Fortunately, the body has a restorative capacity and starts producing new cells. However, these cells are not the same as the original cells. This causes deformity of the hip joint.
Damage to the blood vessels around the hip joint could also be indicated as a cause. This damage can be caused by a trauma (accident). But the development of blood clots can also cause the veins to become blocked. When the joint capsule becomes inflamed, the increased pressure can cause a blockage of the veins.
Symptoms
Calvé’s disease occurs more often in boys than in girls. In 90 percent of cases, it concerns an abnormality in only one hip. Pain often occurs first in the hip, groin or knee. These pain complaints worsen with certain movements. At first the pain is not severe, but over time it progresses. This also makes the movement different. The child does not want to stand or walk, and when he walks he may limp. Lifting the leg sideways is limited.
In dogs, the first complaints often arise are pain, which is manifested by licking or biting the hip. We already see this in the young puppy. The dog can be easily irritable, especially when it comes to touch around the hip. Later the dog will start to walk lame. In severe cases the leg can no longer be used.
Gradations
The disease has four degrees:
- Grade 1: a quarter of the femoral head has died. There is pain when moving.
- Grade 2: half of the femoral head has died. Movement is more difficult, lifting the leg sideways is painful.
- Grade 3: three quarters of the femoral head has died. Walking is almost impossible anymore. The movements do not look natural.
- Grade 4: the entire femoral head has died. The leg can no longer be used. Walking with this leg or paw is no longer possible.
The diagnosis can be made by taking an X-ray. This clearly shows the deformity of the femoral head. This also shows to what extent the femoral head has died. An MRI or bone scan can also be made.
Treatment and recovery
The restorative capacity of the young body is striking. The dead bone is absorbed by the body and replaced by new bone tissue. Because the new bone tissue is still weak, it can quickly collapse under the weight when the patient stands or walks. Treatment therefore consists of a lot of rest. This allows the bone to recover.
In very young children it is sometimes difficult to rest. You can then opt for a spreader brace, where the hip is fixed in a good position. This speeds up healing. It is also possible to make walking easier with the help of a brace. This puts less strain on the hip joint. Crutches or a wheelchair can also be a solution. Many children undergo physiotherapy, where they are taught to adopt the correct posture. This also includes training certain muscle groups. Sometimes it is necessary to apply traction: muscles and tendons are then stretched. In severe cases, surgery is necessary. On average, this disease takes 2 to 5 years to heal.
Dogs are often prescribed medication in the form of painkillers and anti-inflammatories. In other cases, surgery is performed. The femoral head is removed. The pain disappears, but the leg can no longer be used properly. Because a dog has four legs, it is easier for him to go through life on three. It is important that the dog is no longer in pain.
