Legg-Calve-Perthes disease (LCPD) is the insidious onset of idiopathic avascular 
necrosis of the hip in the pediatric population. The disease encompasses a wide 
spectrum of pathology, from mild with no long-term sequelae to severe with 
permanent degenerative change of the hip joint. A pediatric patient with hip 
pathology may initially only present with knee or thigh pain, thus obligating 
the clinician to maintain awareness about the hip during examination. Common 
physical examination findings include deficits in hip abduction and internal 
rotation, along with Trendelenburg gait in late stages. Plain radiographs 
demonstrate changes in the anterolateral aspect of the femoral head, sometimes 
only seen on the frog lateral X-ray in early stages. Treatment options aim to 
restore range of motion and maintain adequate coverage of the femoral head. When 
appropriate, surgery is used to reorient the femoral head or pelvis to maintain 
coverage.