Perthes (also called Legg-Calve-Perthes disease) is a rare childhood condition that affects the hip. It occurs when the blood supply to the head of the femur (thighbone) is temporarily disrupted. Without enough blood to the location, the bone cells die. This is called avascular necrosis. This process can last many years. This typically occurs in children between ages 4 and 10 and is more common in boys than in girls.
The cause of the condition is unknown. One of the earliest symptoms of Perthes is a change in the way your child walks and runs. Your child may limp and/or have decreased motion of the hip joint. Other symptoms include pain in the hip or groin and leg pain that worsens with activity but goes away with rest.
There are four stages of Perthes:
Doctors at Riley at IU Health use X-rays to help diagnosis and monitor. In some cases, a magnetic resonance imaging (MRI) scan is needed to check the progression of the damage and healing of the bone.
Treatment of Perthes may vary based on how old your child is when the condition is diagnosed and how severe the condition is when diagnosed. The goal of treatment is to help the bone grow back into the rounded shape of a normal hip to make sure the head of the femur (the “ball” of the “ball and socket” joint) fits into the hip joint. To do this, it is recommended that your child’s activities be limited. Your child will need to avoid high-impact activities like running and jumping. In some cases, the doctor may recommend crutches or a walker to prevent any weight on the hip joint.
Your child's orthopedic doctor will observe your child by scheduling regular follow-up appointments with X-rays to monitor the joint.
Additional treatment may include anti-inflammatory medicines (such as ibuprofen), casting or surgery to re-establish the proper alignment of the bones of the hip and to keep the head of the femur deep within the joint until healing is complete. The orthopedic surgeon may recommend physical therapy or prescribe exercises that help prevent hip joint stiffness.
More information about Perthes can be found at the online resource below.
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Pediatric Orthopedics & Sports Medicine
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