This is a rare condition (1:18.000 live births) and occurs mostly in Caucasian children aged 4-9 years with a sex predominance of boys (5:1). It is avascular necrosis of the femoral head of unknown cause. It is thought to be related to repeated trauma to the femoral head, which already has poor vascularization. It is more common in children with delayed growth and is bilateral in 10-18 percent of cases. Examination shows limitation of hip movement and X-rays of the hips show the abnormal femoral head. It is important to consinder the diagnosis in a child who has a limp. Treatment involves physical therapy and reduction of weight bearing.
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