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 and usually between the ages of 4-10 years old. 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 results in a flattening of the femoral head. In most cases, this only occurs on the one side.
What Causes Perthes Disease?
Perthes is caused by the interruption of blood flow as explained above. The cause of this interruption remains unknown.
What are the Symptoms of Perthes Disease?
Symptoms of Perthes disease include:
How is Perthes Disease Diagnosed?
Clinical examination findings include an observable limp with walking and decreased hip joint range of motion.
An X-ray may show the flattening of the femoral head, often in the initial stages changes cannot be seen on an X-ray but may be demonstrated by successive x-rays. At times an MRI or bone scan may also be required.
Perthes Disease Treatment
For children under the age of 6 treatment is usually conservative and doesn’t require surgery. This is because they are young and their bones still have a lot of growing and developing and the femoral head has more time to repair. Conservative management is where you 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:
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 may be required in more severe cases. Surgery is aimed at improving joint alignment and the contour of the femoral head. Surgical methods range from releasing tight muscles around the hip to joint realignment. Post surgery, your physiotherapist can help to provide stretching and strengthening exercises to assist with recovery and a return to activity.
Perthes Disease Prognosis
Sometimes those who have had Perthes disease require a joint replacement later in life. Children who have had 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 or has had Perthes, the physiotherapy team at PhysioWorks has the ability to help your child get back into normal activities and sport, and simply be a child again.
Common Hip Treatments
Hip Joint Pain
Lateral Hip Pain
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