Perthes Disease

Perthes Disease

John Miller Physiotherapist

Article by John Miller

Perthes Disease

What is Perthes Disease?

Legg-Calve-Perthes Disease, or Perthes Disease for short, is a rare condition that affects children. It affects boys more than girls, usually between the ages of 4-10. It affects the hip joint and involves the femoral head (the ball part at the top of the thigh bone). The blood supply to this area of the bone becomes interrupted. With insufficient blood flow, the bone begins to die (avascular necrosis). This bone death results in a flattening of the femoral head. In most cases, this only occurs on one side.

What Causes Perthes Disease?

The interruption of blood flow, as explained above, causes Perthes. The cause of this interruption remains unknown.

What are the Symptoms of Perthes Disease?

Symptoms of Perthes disease include:

  • Limping- may or may not be related to pain.
  • Hip joint stiffness
  • Pain in the hip, groin, thigh or knee
  • Decreased range of movement of the hip
  • Shortening of the affected leg
  • Atrophy (wasting) of the surrounding muscles

How is Perthes Disease Diagnosed?

Clinical examination findings include a visible limp with walking and decreased hip joint range of motion. An X-ray may show the flattening of the femoral head. Changes cannot be seen on an X-ray in the initial stages but may be demonstrated by successive x-rays. At times an MRI or bone scan may also be required.

Please consult your hip physiotherapist or doctor for diagnostic assistance regarding Perthes Disease.

Perthes Disease Treatment

For children under 6, treatment is usually conservative and doesn’t require surgery. Because they are young and their bones still have a lot of growing and developing, the femoral head has more time to repair. Conservative management is where your physiotherapist can assist. Your child will require rest from high-intensity activities, including running, to prevent further damage to the hip joint.

Physiotherapy treatment will involve:

  • Advice and education on the condition and providing recommendations on relevant rest to assist with decreasing pain
  • Stretching exercises for the hip
  • Progressive strengthening exercises for the hip and leg
  • Crutches to decrease weight-bearing if walking is particularly sore

At times conservative treatment may also involve traction, where the hip is gently pulled out from the socket to help relieve pain; or casting to maintain femoral head alignment.

Surgery aims to improve joint alignment and the contour of the femoral head. Surgical methods range from releasing tight muscles around the hip to joint realignment. Surgery may occur in more severe cases. Post-surgery, your physiotherapist can help provide stretching and strengthening exercises to assist with recovery and a return to activity.

Perthes Disease Prognosis

Sometimes those with Perthes disease require a joint replacement later in life. Children with Perthes are also more likely to develop early onset of hip arthritis.

Your physiotherapist can aid in the detection and diagnosis of Perthes disease. If your child has had Perthes, the physiotherapy team at PhysioWorks can help your child get back into normal activities and sports and be a child again.

Introduction to Hip & Groin Pain

Hip and groin pain affects a wide array of individuals, from athletes to the elderly. Understanding the common causes and treatments of this pain is vital for maintaining overall well-being and mobility.

Common Causes of Hip Pain

hip & groin pain
Hip &Amp; Groin Pain Causes &Amp; Treatment

Lateral Hip Pain and Its Causes

Groin Pain: Different Types and Causes

Other Muscle-Related Pain

Systemic Diseases Affecting the Hip

Referred Pain Sources

  • Sciatica: Pain radiating along the sciatic nerve, which runs from the lower back through the hips and down the legs.
  • Lower Back Pain: Can refer pain to the hip area.
  • Pinched Nerve: Nerve compression in the spine or hip area.

Hip Surgery: A Solution for Severe Cases

What's New in Hip & Groin Pain Research?

Recent studies suggest the importance of tailored exercise programs in managing hip and groin pain. Physiotherapy techniques focusing on strengthening and stabilising the deep hip rotators and core muscles have shown significant improvements in pain management and mobility.

What to Do? Seeking Professional Advice

If you're experiencing hip or groin pain, it's crucial to consult with a physiotherapist or doctor.

They can assess your condition, provide a personalised treatment plan, and guide you through exercises tailored to your specific needs.


Hip and groin pain can significantly impact your quality of life. However, with the right knowledge and professional guidance, managing and overcoming this pain is achievable.

Related Articles

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  2. Hip, Groin & Buttock Pain FAQs: Symptoms, Causes, Treatments - Answers to frequently asked questions about hip, groin, and buttock pain, including symptoms, causes, and treatments​​.
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Hip, Groin, Buttock Pain FAQs

Welcome to our comprehensive FAQ section, designed to address your concerns about hip, groin, and buttock pain. Here, we aim to provide clear, accessible information to help you understand the potential causes of your discomfort and the various treatment options available. Our physiotherapy experts have compiled a series of questions and answers to guide you through common issues, from hip impingement to sciatica, and everything in between. For more in-depth exploration, we've linked to related articles on our website, allowing you to delve deeper into each topic.

Hip, Groin, Buttock Pain
Hip, Groin, Buttock Pain Faqs

Hip Pain FAQs

Dealing with hip pain can be challenging, impacting your mobility and quality of life. Explore our detailed articles for insights on diagnosis, treatment options, and the importance of hip core muscles in maintaining joint health.

Lateral Hip Pain FAQs

Lateral hip pain, including conditions like gluteal tendinopathy and hip bursitis, requires targeted treatment strategies. Discover effective physiotherapy approaches to manage and alleviate your pain.

Groin Pain FAQs

Groin pain can significantly affect your ability to perform daily activities. Learn how to recognise serious symptoms and find effective relief methods through our expert advice.

Buttock Pain FAQs

Buttock pain, including conditions like SIJ pain and sciatica, can be debilitating. Our articles offer insights into symptoms, causes, and comprehensive treatment options to help you recover.


Our FAQ section is designed to be your go-to resource for hip, groin, and buttock pain. Whether you're dealing with a temporary discomfort or a chronic condition, understanding your symptoms and knowing the best treatment options is crucial. Remember, while our website provides valuable information, consulting a physiotherapist for a tailored diagnosis and treatment plan is always recommended. Explore our related articles for more in-depth knowledge and take the first step towards a pain-free life today.

Related Articles

  1. Greater Trochanteric Pain Syndrome (GTPS) - Readers can learn about the causes and management of pain near the greater trochanter, which is closely related to lateral hip pain.
  2. Trochanteric Bursitis - Hip Bursitis: Causes & Treatments - This article explains the causes of hip bursitis and offers treatment solutions, relevant to those experiencing lateral hip pain.
  3. Gluteal Tendinopathy: Causes, Symptoms, And Treatment - Offers insights into the causes and treatment of hip tendinitis, a condition linked to lateral hip pain.
  4. Hip Adductor Tendinopathy - Effective Physio Solutions - Focuses on groin pain caused by inflammation or degeneration of tendons in the hip region, directly relevant to the groin pain FAQ.
  5. Hip Flexor: Iliopsoas Groin Pain: Causes And Treatment - Provides detailed information on hip flexor issues, which can cause groin pain, making it highly relevant to readers of the original article.
  6. Hip & Groin Pain Guide: Causes, Treatment, Physio Advice - A comprehensive guide on hip and groin pain, covering common causes and treatments that align with the article's topics.
  7. Piriformis Syndrome - Understanding & Physio Treatment Tips - Discusses piriformis syndrome, a condition causing buttock pain, which is directly related to one of the SEO keywords.
  8. What Is Hip Impingement? - Explains hip impingement, a condition causing hip and sometimes groin pain, providing valuable insights into potential causes of the reader's discomfort.
  9. Sacroiliac Joint Dysfunction (SIJ) Causes, Relief, Treatment - Relevant for readers experiencing buttock pain, as it covers SIJ pain, a topic mentioned in the original article.
  10. Hip Arthritis - While not directly mentioned in the FAQ sections, hip arthritis can be a source of hip pain, making this article useful for readers wanting to understand more about hip conditions and pain management.
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