In Legg-Calve-Perthes disease, when is pain typically most intense and requires management?

• A. Daytime
• B. Night
• C. After meals
• D. During activity

Answer: (B)

Pain in Legg-Calve-Perthes disease often becomes most troublesome when the child is at rest, especially at night. When the body slows down and the hip is not bearing as much dynamic load, the joint can become stiff and the necrotic bone and surrounding tissues may irritate the joint capsule, leading to nocturnal discomfort. Because sleep is frequently disrupted by this pain, nighttime management is a key part of care. To address it, provide age-appropriate pain relief before bed (as advised by a clinician), use comfortable hip positioning to reduce stress on the joint during sleep, and maintain gentle range-of-motion activities during the day to preserve mobility. This pattern—nighttime pain requiring control—helps prevent prolonged sleep disturbance and supports overall healing and function as the condition evolves.