M91.2 Coxa plana

Name of the Condition

• Coxa Plana
• Also known as Legg-Calvé-Perthes disease.

Summary

Coxa plana refers to the flattening of the femoral head in the hip joint, typically due to a temporary loss of blood supply. It's most common in children and can lead to hip pain and limping.

Causes

The exact cause is unclear, but it's believed to result from disrupted blood flow to the femoral head. May be related to genetic factors, trauma, or inflammation.

Risk Factors

• Age: Most commonly affects children between 4 and 10 years old.
• Gender: More prevalent in boys than girls.
• Family History: Genetics may play a role.
• Exposure to secondhand smoke: Some studies suggest an association.

Symptoms

• Limping or difficulty walking.
• Hip or groin pain that may extend to the thigh or knee.
• Stiffness and reduced range of motion in the hip.

Diagnosis

Diagnosis involves a physical examination to assess hip movement and pain levels, followed by imaging studies such as X-rays and MRI scans to observe changes in the femoral head.

Treatment Options

• Rest and Activity Modification: Reducing weight-bearing activities to prevent further damage.
• Physical Therapy: To maintain hip range of motion.
• Medications: Pain relief medications such as NSAIDs.
• Surgery: In severe cases, procedures like osteotomy to reshape the femoral head may be considered.

Prognosis and Follow-Up

Prognosis depends on the severity of the condition and the age of onset. Early diagnosis and appropriate management can improve outcomes. Regular follow-up with a healthcare provider is important to monitor hip development and function.

Complications

• Hip deformity: Persistent flattening of the femoral head.
• Arthritis: Increased risk of developing hip arthritis later in life.
• Limited mobility: Long-term stiffness or reduced range of motion.

Lifestyle & Prevention

• Avoid high-impact activities: Reduce stress on the hip joint.
• Maintain a healthy weight: Minimize additional load on the hip.
• Smoking cessation: Eliminate secondhand smoke exposure if applicable.

When to Seek Professional Help

Seek medical attention if a child develops a limp, hip pain, or reduced mobility. Early evaluation is crucial for effective management.

Tips for Medical Coders

Document the affected hip (e.g., right, left, bilateral) and any associated symptoms or complications. Ensure clinical documentation supports the diagnosis and aligns with the specific code M91.2 for coxa plana.