Perthes’ disease is a condition of the hip joint that tends to affect children between the ages of three and 11 years.
The top end of the thigh bone (femur) is shaped like a ball so that it can fit snugly into the hip socket. In Perthes’ disease, this ball (femoral head) is softened and eventually damaged due to an inadequate blood supply to the bone cells.
Boys are more likely to develop Perthes’ disease than girls. In most cases only one hip joint is affected.
Most children with Perthes’ disease eventually recover, but it can take anywhere from two to five years for the femoral head to regrow and return to normal, or close to normal.
Perthes’ disease is also known as Legg-Calve-Perthes disease or coxa plana.
The symptoms of Perthes’ disease include:
Our bones need a regular supply of blood to stay healthy. Blood provides our bones with oxygen and other nutrients. In children with Perthes’ disease blood supply to the femoral head is disrupted. We don’t know what causes this to occur. Without enough oxygen and nutrients, the bone cells of the femoral head die.
Your doctor will do a number of examinations and tests to work out what’s causing your child’s symptoms.
These will include:
Other tests may also be required and include:
These will give your doctor a picture of what’s happening inside your child’s joints.
In most cases, the blood supply to the hip joint returns and the femoral head regenerates by itself. This can take anywhere between two and five years. During this critical period, the bone is soft and vulnerable to damage.
Treatment of Perthes’ disease aims to make sure the femoral head remains as round as possible, and to reduce joint pain and stiffness.
Treatment depends on your child’s age and the severity of their condition, but may include:
In most children, the blood supply to the hip joint returns and the femoral head regenerates by itself. This can take anywhere between two and five years.
During this time provide understanding and support to help your child find other activities they can enjoy that don’t require weight bearing on the affected leg.
Generally speaking, the younger the child is when they develop Perthes’ disease, the better the outcome. The degree of damage to the femoral head also determines the long term outlook.
Some children may develop osteoarthritis in the affected joint later in life, and in rare cases, hip replacement surgery may be required.
However most children respond well to treatment and are able to get back to their usual activities.
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Information has been produced in consultation with and approved by: Musculoskeletal Australia.