Bilateral legg-calve-perthes disease and kienbock’s disease in a child with factor V Leiden thrombophilia: A case report

Heather L. Baltzer, Scott Riester, Steven L. Moran

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: The etiology of multifocal osteonecrosis is not definitively known; however, hypercoagulable state is a very plausible cause. Methods: We present an unusual case of a 12-year-old boy with a history of Legg-Calve-Perthes disease presenting with right wrist pain who was subsequently diagnosed with Kienbock’s disease. The finding of multifocal osteonecrosis prompted testing for a hypercoagulable state that was positive for Factor V Leiden thrombophilia. A thorough literature review using Medline database was conducted to investigate associations between inherited hypercoagulable states and multifocal osteonecrosis. Results: Our literature review identified 2 similar cases of multifocal osteonecrosis associated with a hypercoagulable disorder in adult patients. There were no reports among the pediatric patient population. Meta-analysis has demonstrated a potential link between Legg-Calve-Perthes disease and Factor V Leiden thrombophilia. Conclusions: This study offers further evidence to support the theory that multifocal osteonecrosis may be linked to a hypercoagulable state. Patients presenting with multifocal osteonecrosis should undergo screening for hypercoagulable states. Further investigation is needed to ascertain the potential benefit of prophylactic anticoagulation in patients with a known hypercoagulable state and multifocal osteonecrosis.

Original languageEnglish (US)
Pages (from-to)NP16-NP19
Issue number3
StatePublished - Sep 2016


  • Avascular necrosis
  • Factor V Leiden
  • Kienbock’s
  • Legg-Calve-Perthes disease
  • Lunate

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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