Hip & FemurCo-occurrence of Blount’s disease and Legg-Calvé-Perthes disease: is obesity a factor?Jardaly, Achraf Ha,b; Hicks, James Wb; Doyle, John Sb,c; Conklin, Michael Jb,c; Gilbert, Shawn Rb,c Author Information aLebanese American University, Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon bDepartment of Orthopedic Surgery, University of Alabama at Birmingham cDepartment of Pediatric Orthopaedics, Children’s Hospital of Alabama, Alabama, USA Received 17 February 2021 Accepted 25 April 2021 Correspondence to Shawn Gilbert, MD, ACC Suite 316, Children’s Hospital, 1600 7th Avenue South, Birmingham, AL 35233, USA Tel: +1 205 638 9540; fax: +1 205 638 6049; e-mail: [email protected] Journal of Pediatric Orthopaedics B: March 2022 - Volume 31 - Issue 2 - p e180-e184 doi: 10.1097/BPB.0000000000000888 Buy Metrics Abstract Legg-Calvé-Perthes disease (LCPD) and Blount’s disease share a similar presenting age in addition to similar symptoms such as limp or knee pain. A little overlap is mentioned about both diseases. We sought to present cases of children having both conditions to discuss the implications of this co-occurrence on diagnosis and management. After institutional review board approval, we retrospectively reviewed records of four children who developed both Blount’s disease and LCPD. Patient details and outcomes were analyzed. Radiographs were evaluated for the lateral pillar classification, Stulberg classification, tibial metaphyseal-diaphyseal angle and tibiofemoral angle. Two of the cases were initially diagnosed with Blount’s disease and subsequently developed Perthes, one case presented initially with both disorders and the final case had Perthes followed by Blount’s. Three children were obese and one was overweight. The common symptom to all patients was an abnormal gait, which was painless in two children and painful in two. Blount’s disease required surgery in three children. Radiographs showed Lateral Pillar B, B/C border and C hips, and the final Stulberg was stage II (n = 2) or stage IV (n = 2). Obesity is associated with Blount’s disease and LCPD, so obese children can be at an increased risk of developing both disorders. Therefore, a child with Blount’s disease who has persistent, recurrent or worsening symptoms such as gait disturbance or thigh or knee pain might benefit from a careful physical exam of the hips to prevent a delayed or even missed LCPD diagnosis. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.