Perthes Disease

what is perthes disease?

The hip is a ball and socket joint that connects the thigh bone (femur) to the pelvis (acetabulum). The hip joint is the largest weight bearing joint in the body. The hip joint is surrounded by strong ligaments and muscles.
Perthes disease is a rare childhood condition that occurs following temporary disruption to the blood supply of the femoral head causing the bone cells to die. This leads to the femoral head becoming weakened and gradually losing its normal round shape. Once the blood supply returns to the femoral head, the bone begins to regrow but sometimes the abnormal shape of the femoral head remains.
Treatment options aim to help the femoral head grows back in a rounded shape.

what are the causes?

Although some studies suggest the development of Perthes Disease is related to family history, the cause is largely unknown. It usually occurs in children aged 4-10 years old and is more common in boys than girls.

what are the symptoms?

The common symptoms of Perthes Disease include:

  • Change in the way your child walks or runs
  • Your child may experience a limp, a limited range of motion, or develop a change in running style
  • Pain:
    • In the hip or groin or deferred pain that develops in the knee or thigh
    • Worsens on activity
    • Painful muscle spasms

how is perthes disease diagnosed?

Your doctor will ask you questions about our child’s symptoms and medical history including family history. Your doctor will also examine the affected hip to assess range of motion. An x-ray of the joint will show the degeneration of the femoral head.

how is perthes disease treated?

The treatment for Perthes Disease involves monitoring the disease progression and treating the bone deformities until the bone regenerates. This process can be up to 2 years.

X-rays will be taken regularly to monitor the disease progression until the bone has regrown.
In young children, where degeneration of the femoral head is mild, non-surgical conservative treatment will be recommended until the bone regrows. These measures include:

  • Observation
  • Anti-inflammatory medication
  • Physiotherapy
  • Avoiding sports and activities that involve jumping and running
  • Casting and bracing.

Your surgeon may recommend surgical treatment to realign the bones within the hip joint and to help the femoral head fit snuggly within the socket (acetabulum). This is usually recommended for older children or in those children where non-surgical treatment options have not been successful. Physiotherapy is required following surgery to strengthen the joint and the surrounding muscles.

Treatment is aimed at maintaining the round shape of the femoral head as arthritis can develop in adulthood in hips where there has been loss of the normal shape of the hip.